rufinamide / Generic mfg. - LARVOL DELTA

Postanastetic Rufinamide Syndrome, an Update (AES 2025) - "AEs were associated with elevated RUF. concentrations that persist for more than a month as the elimination of RUF is decreased. It is important to obtain baseline levels (personal therapeutic levels) when a person has attained their therapeutic goal."

Anesthesia • Anorexia • CNS Disorders • Epilepsy

A Rare Case of Adult-Onset Lennox-Gastaut Syndrome and possible association with Retinitis Pigmentosa (AES 2025) - "After a month, she was readmitted for breakthrough seizures which progressed to status epilepticus and her epilepsy became intractable, necessitating her to be on multiple antiseizure medications including phenytoin, clobazam, rufinamide, valproic acid, levetiracetam, and topiramate. This is an unusual case of late onset LGS that manifested in adulthood and rapidly became medically intractable. It was associated with simultaneous development of ophthalmologic findings suggestive of retinitis pigmentosa. Adult onset LGS has only been described in 3 cases in the literature."

Clinical • CNS Disorders • Developmental Disorders • Epilepsy • Genetic Disorders • Inherited Retinal Dystrophy • Ocular Inflammation • Ophthalmology • Retinal Disorders • Retinitis Pigmentosa

Spectrum of Lennox-Gastaut Syndrome in Adulthood: Clinical Features of 18 patients (AES 2025) - "Fenfluramine (FFA), formerly used as an appetite suppressant, has recently been approved for the treatment of LGS and has shown promising efficacy. A significant proportion of adult LGS patients did not fulfill the updated ILAE criteria. While these criteria refine the diagnosis of LGS, their strict application may limit access to syndrome-specific medications such as FFA and rufinamide (RUF). Nonetheless, seizure reduction was observed in patients treated with FFA based on classical diagnostic criteria, as demonstrated in our cohort."

Clinical • CNS Disorders • Developmental Disorders • Epilepsy • Mental Retardation

EPIPOP: Population Pharmacokinetics of Antiepileptic in Pediatrics (clinicaltrials.gov) - P=N/A | N=753 | Completed | Sponsor: Assistance Publique - Hôpitaux de Paris | Recruiting ➔ Completed

Trial completion • CNS Disorders • Epilepsy • Pediatrics

Establishing a fast-track screening method for rufinamide derivatives using Drosophila melanogaster to identify potential antiepileptic drugs in genetically at-risk populations (Neuroscience 2025) - "The platform holds particular promise for addressing treatment gaps in underserved populations with distinct genetic backgrounds, such as those in Puerto Rico. By democratizing drug development tools and emphasizing genetic relevance, this work lays the foundation for targeted, next-generation epilepsy therapeutics."

Clinical • CNS Disorders • Epilepsy • NAV1

AN ELUSIVE CASE OF SUPER REFRACTORY STATUS EPILEPTICUS (CHEST 2025) - "His seizures were uncontrolled despite high doses of propofol (70 mcg/kg/min), and other AEDs were also added incrementally (levetiracetam 2 g twice daily, lacosamide 200 mg twice daily, valproic acid 500 mg every 6 hours, topiramate 200 mg every 12 hours, phenobarbital 130 mg daily, perampanel 16 mg daily (after a loading dose of 24 mg)...We also performed plasmapheresis (every other day for 5 times), pulse dose steroids (1 g intravenous methylprednisolone for 5 days) till auto-immune and paraneoplastic workup came back as negative...Commonly used IVAs include midazolam, pentobarbital, and propofol, with alternatives being ketamine, isoflurane, desflurane and brexanolone. Commonly used AEDs are phenobarbital, phenytoin, fosphenytoin, levetiracetam, valproate, and lacosamide, while some of the newer ones include brivaracetam, clobazam, and rufinamide... SRSE is a complex clinical condition requiring further research to establish optimal management tactics. Our patient..."

Clinical • Addiction (Opioid and Alcohol) • Aesthetic Medicine • Anesthesia • Epilepsy • Immunology • Infectious Disease • Pneumonia • Respiratory Diseases • Septic Shock • Vascular Neurology

Epidemiology and Burden of Illness of Lennox-Gastaut Syndrome in Taiwan: A Retrospective Cohort Study. (PubMed, Risk Manag Healthc Policy) - "Confirmed LGS was defined by International Classification of Diseases-10 (ICD-10) LGS codes or ≥1 rufinamide prescription; probable LGS was defined as patients aged ≤10 years when receiving ≥3 antiseizure medications (ASMs), with ICD-9/10 codes for developmental delay...Most prescribed ASMs were valproate (89%), levetiracetam (83%), clonazepam (69%), clobazam (68%), and topiramate (65%)...Although prevalence and incidence of LGS in Taiwan were lower than in other countries, the multifaceted burden of illness in LGS is highlighted herein. Reduced hospitalizations through better epilepsy control may reduce LGS expenditure."

Journal • Retrospective data • CNS Disorders • Developmental Disorders • Epilepsy • Pediatrics

Rufinamide Mitigates Seizures and Behavioural Deficits via BDNF/TrkB Modulation and Oxidative Stress Reduction in Pentylenetetrazole-Kindled Mice. (PubMed, Clin Exp Pharmacol Physiol) - "It is possible that the effects of RUF that have been seen are the consequence of decreased oxidative stress, BDNF/TrkB downregulation, and reduced expression of neuroinflammatory markers, which in turn reduce ictogenesis and improve the neuropsychiatric consequences associated with epilepsy."

Journal • Preclinical • Alzheimer's Disease • CNS Disorders • Epilepsy • Mood Disorders • Pain • Psychiatry • BDNF • NTRK2

In Silico Evaluation of Quinolone-Triazole and Conazole-Triazole Hybrids as Promising Antimicrobial and Anticancer Agents. (PubMed, Int J Mol Sci) - "faecalis, M. tuberculosis, S. aureus, E. coli, M. smegmatis, P. aeruginosa and EGFR, MPO, VEGFR, CDK6, MMP1, Bcl-2, LSD1, HDAC6, Aromatase, ALOX15) and comparing them with established drugs such as ampicillin, cefatrizine, fluconazole, gemcitabine, itraconazole, ribavirin, rufinamide, streptomycin, and tazobactam, compounds 15 and 16 emerged as noteworthy antimicrobial and anticancer agents, respectively. This finding reveals a well-defined, possibly therapeutic relationship, supported by theoretical and future in vitro and in vivo studies. Compounds 15 and 16, thus, emerged as intriguing contenders in the fight against infectious diseases and cancer."

Journal • Infectious Disease • Oncology • Pulmonary Disease • Respiratory Diseases • Tuberculosis • ALOX15 • BCL2 • CDK6 • EGFR • MMP1

Innovative first-order UV and fluorescence spectroscopic methods for the quantification of rufinamide in the presence of its toxic degradant: Application of AGREE tool. (PubMed, Spectrochim Acta A Mol Biomol Spectrosc) - "The RUF's fluorescence and the oxidative degradant (OXD) emission appeared at 406 and 426 nm, following the excitation at 373 and 368 nm respectively. The limit of quantitation (LOQ) values were of 0.14 and 0.27 μg mL-1, while the limit of detection (LOD) values were 8.19 and 0.41 μg mL-1 for spectrophotometric and spectrofluorometric methods respectively. AGREE and analytical eco-scale was two of the tools used to assess and approve the proposed method's greenness."

Journal • CNS Disorders • Epilepsy

Drug-resistant Epilepsy: Which Drugs are Substrates of P-glycoprotein and Which are Not? (PubMed, Curr Neuropharmacol) - "among the anticrisis medications, the following are likely substrates of P-glycoprotein: Phenytoin, Phenobarbital, Oxcarbazepine, Lamotrigine, Topiramate, and Lacosamide (less evidence). The following are probably not substrates: Brivaracetam, Zonisamide, Valproic acid, Perampanel, Gabapentin, and Vigabatrin. We have not obtained enough information about: Carbamazepine, Eslicarbazepine, Levetiracetam, Tiagabine, Felbamate, Pregabalin, Rufinamide, Ezogabine, and Retigabine."

Journal • CNS Disorders • Epilepsy

Neuroinflammation leads to pharmacoresistance in temporal lobe epilepsy via promoting spermine degradation. (PubMed, Acta Pharmacol Sin) - "LPS induced-neuroinflammation significantly decreased the antiseizure efficacy of phenytoin (PHT), carbamazepine (CBZ) and rufinamide (RUF), all the ASMs tested were unable to alleviate the seizure severities. Finally, intrahippocampal injection of spermine restored the efficacy of ASMs on action potential firings and sodium currents, resulting in the reversal of pharmacoresistance in LPS-treated TLE models. These results provide new evidence that neuroinflammation causes pharmacoresistance in TLE via promoting spermine degradation, and highlight spermine supplementation as a promising therapy for pharmacoresistant TLE."

Journal • CNS Disorders • Epilepsy • Inflammation

Current and emerging pharmacotherapies in lennox-Gastaut syndrome. (PubMed, Expert Opin Pharmacother) - "This review examines FDA-approved medications for LGS (clonazepam, felbamate, lamotrigine, topiramate, rufinamide, clobazam, cannabidiol, and fenfluramine), commonly used off-label antiseizure medications, emerging treatments in clinical trials, and precision therapeutics targeting etiology-specific mechanisms. Future progress depends on improved natural history studies, standardized data collection, advanced preclinical models, innovative trial designs, and addressing healthcare inequities. While emerging precision therapies targeting genetic causes show promise, the field urgently needs better strategies to optimize existing treatments while developing disease-modifying approaches that address both seizures and non-seizure outcomes."

Journal • Review • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Epilepsy • Gene Therapies

Seizure-type-specific treatment responses in Lennox-Gastaut Syndrome: A comprehensive review of pharmacological, neuromodulatory, dietary, and surgical therapies. (PubMed, Epilepsy Behav) - "Generalized tonic-clonic seizures (GTCS) show favorable responses to antiseizure medications (ASMs) such as felbamate, lamotrigine, topiramate, fenfluramine, lacosamide, and perampanel. Myoclonic seizures tend to respond better to clonazepam, topiramate, zonisamide, brivaracetam, and perampanel, but may show limited responsiveness to neuromodulation and CC. Atypical absence seizures may respond to valproate, topiramate, and rufinamide, but show poor responses to brivaracetam and perampanel...This review underscores the importance of tailoring treatment to predominant seizure types and calls for more rigorous, seizure-type-specific outcome reporting in future clinical trials, along with the need for long-term studies. The findings advocate for a precision, network-based approach to treatment, where therapeutic decisions are guided by individual seizure patterns and supported by evidence-based, seizure-type-specific efficacy data."

Journal • Review • Absence Seizure Disorder • CNS Disorders • Epilepsy

Recent Advances in Ionic Mechanisms in Pituitary Cells: Implications for Electrophysiological and Electropharmacological Research. (PubMed, J Clin Med) - "The presence of esaxerenone, an antagonist of the aldosterone receptor, directly suppresses the magnitude of peak and late INa. Risperidone, an atypical antipsychotic agent, is effective at suppressing the IK(erg) amplitude directly, and di(2-ethylhexyl)-phthalate suppressed IK(erg). Solifenacin and kynurenic acid can interact with the KM channel to stimulate IK(M), while carisbamate and cannabidiol inhibit the Ih amplitude activated by sustained hyperpolarization. Moreover, the presence of either rufinamide or QO-40 can enhance the activity of single BKCa channels. To summarize, alterations in ion currents within native pituitary cells or pituitary tumor cells can influence their functional activity, particularly in processes like stimulus-secretion coupling. The effects of small-molecule modulators, as demonstrated here, bear significance in clinical, therapeutic, and toxicological contexts."

Journal • Review • CNS Disorders • Endocrine Cancer • Oncology • Pituitary Gland Carcinoma

Effectiveness and safety of single anti-seizure medication as adjunctive therapy for drug-resistant focal epilepsy based on network meta-analysis. (PubMed, Front Pharmacol) - "Compared to placebo, the following ASMs demonstrated statistically significant effectiveness in achieving a 50% response rate: brivaracetam (RR = 2.07, 95% CI: 1.53-2.81), cenobamate (RR = 2.12, 95% CI: 1.56-2.88), eslicarbazepine acetate (RR = 1.95, 95% CI: 1.41-2.70), gabapentin (RR = 2.30, 95% CI: 1.76-3.02), lacosamide (RR = 2.22, 95% CI: 1.47-3.35), lamotrigine (RR = 1.55, 95% CI: 1.00-2.40), levetiracetam (RR = 2.43, 95% CI: 1.88-3.15), oxcarbazepine (RR = 3.03, 95% CI: 2.08-4.40), perampanel (RR = 1.72, 95% CI: 1.21-2.44), pregabalin (RR = 2.06, 95% CI: 1.70-2.50), rufinamide (RR = 2.28, 95% CI: 1.20-4.31), tiagabine (RR = 4.07, 95% CI: 2.03-8.18), topiramate (RR = 3.10, 95% CI: 2.44-3.95), vigabatrin (RR = 2.34, 95% CI: 1.58-3.46), and zonisamide (RR = 2.40, 95% CI: 1.76-3.27). Additionally, comprehensive safety data for tiagabine and levetiracetam are lacking, necessitating further research. Larger studies are required to solidify these findings and better..."

Journal • Retrospective data • Review • Ataxia • CNS Disorders • Epilepsy • Fatigue • Movement Disorders • Pain

Development of isatin-functionalized benzenesulfonamides as novel carbonic anhydrase II and VII inhibitors with antiepileptic potential. (PubMed, Eur J Med Chem) - "The design exploits a one-tail approach, integrating a sulfonamide warhead for zinc coordination in the CA active site, a triazole linker (inspired by FDA-approved antiepileptic rufinamide), and an isatin-based tail...The anticonvulsant activity of five carbonic anhydrase inhibitors (5c, 5e, 5f, 7a, and 7d) was assessed using PTZ and pilocarpine-induced convulsions in mice...Additionally, biochemical evaluation revealed that both compounds restored hippocampal KCC2 and mTOR levels, suggesting their role in modulating neuronal excitability and ionic balance. Safety assessments, including Rotarod and biochemical toxicity tests, confirmed their favorable safety profile, supporting their potential as promising anticonvulsant candidates."

Journal • CNS Disorders • Epilepsy

Efficacy and safety of pharmacological and non-pharmacological therapies in Lennox-Gastaut syndrome: a systematic review and network meta-analysis. (PubMed, Front Pharmacol) - "The treatments assessed included cannabidiol, fenfluramine, clobazam, rufinamide, felbamate, lamotrigine, topiramate, deep brain stimulation, and anterior corpus callosotomy. Clobazam 1 mg/kg/day, anterior corpus callosotomy, and rufinamide manifested the most optimal efficacy in seizure control among LGS patients. Caution should be exercised when administering cannabidiol, lamotrigine, and fenfluramine 0.7 mg/kg/day in clinical practice to mitigate safety concerns associated with drug-related side effects."

Journal • Retrospective data • Review • CNS Disorders • Epilepsy

Case Report: White-Sutton syndrome and cannabidiol, an update on a reported patient with a successful response to off--label therapy. (PubMed, Front Pediatr) - "Despite various therapeutic attempts, including valproate, topiramate, levetiracetam, clobazam, rufinamide, and vigabatrin, the patient's seizures persisted. Although CBD shows promise in other epileptic syndromes, this case highlights its potential effectiveness in this specific condition. This manuscript aims to contribute to the understanding of WSS and advocate for further research into novel treatments, particularly the role of CBD in managing epilepsy within this complex clinical context."

Journal • CNS Disorders • Developmental Disorders • Epilepsy • Gastrointestinal Disorder • Genetic Disorders • Mental Retardation • Pediatrics

Sustainability and Techno-Economic Assessment of Batch and Flow Chemistry in Seven Industrial Pharmaceutical Processes. (PubMed, ACS Sustain Chem Eng) - "This work addresses this gap by presenting a detailed comparison of batch and flow syntheses of seven industrially relevant APIs, including amitriptyline hydrochloride, tamoxifen, zolpidem, rufinamide, artesunate, ibuprofen, and phenibut. Specifically, manufacturing certain APIs in flow show lower-than-average improvements in operating expenditure and land system changes, the latter being directly correlated with the consumption of organic solvents, that can be comparable to or even higher than in batch. These challenges highlight the need for further optimization of flow processes to fully realize their potential in API production."

Journal

Antiseizure medications for Lennox-Gastaut Syndrome: Comprehensive review and proposed consensus treatment algorithm. (PubMed, Epilepsy Behav) - "To date, eight anti-seizure medications (ASMs) have been specifically approved by the U.S. Food and Drug Administration (FDA) for the treatment of LGS: clonazepam, felbamate, lamotrigine, topiramate, rufinamide, clobazam, cannabidiol, and fenfluramine. Barriers to access, including economic and regulatory hurdles, are also discussed. The proposed treatment algorithm emphasizes a personalized approach to LGS management, recommending valproate or clobazam as first-line treatments, followed by individualized combinations based on the specific patient profile and associated comorbidities."

Journal • Review • CNS Disorders • Epilepsy

Cognitive and behavioral impact of antiseizure medications, neuromodulation, ketogenic diet, and surgery in lennox-gastaut syndrome: A comprehensive review. (PubMed, Epilepsy Behav) - "Medications such as valproate, lamotrigine, cannabidiol, fenfluramine, levetiracetam, brivaracetam, felbamate, and rufinamide generally support cognitive stability, while topiramate and zonisamide are associated with cognitive challenges. Behavioral outcomes also vary: stability is observed with valproate, lamotrigine, rufinamide, cannabidiol, and fenfluramine, whereas medications like levetiracetam, perampanel, brivaracetam, clobazam, and zonisamide can increase aggression or irritability...Consideration of minimizing ASM polytherapy, careful evaluation of drug-drug interactions, pharmacogenomic implications, and the need for therapeutic drug monitoring in cases of cognitive adverse effects is essential. Future research should focus on developing assessment tools tailored to the unique needs of individuals with LGS, utilizing connectivity measures to assess intervention impacts, and advancing precision therapeutics to improve cognitive and behavioral outcomes."

Journal • Review • CNS Disorders • Developmental Disorders • Epilepsy • Mental Retardation • Psychiatry

Clinical value of saliva therapeutic drug monitoring of newer antiseizure medications. (PubMed, Seizure) - "This large newer ASM paired plasma-saliva collection allows to precise the potential use of saliva in the management of epilepsy, especially for commonly used ASM such as lamotrigine and levetiracetam. Although they correlate well, extrapolating plasma levels from saliva samples is still an imprecise approximation, making it inadequate for fine dosage adjustments. Yet, a very low saliva level has an appreciable discriminative ability for low plasma level. Unstimulated saliva represents a convenient non-invasive alternative to plasma, to readily identify compliance issues or major drug-drug interactions."

Journal • CNS Disorders • Epilepsy

Promising therapeutic strategies for lennox-gastaut syndrome: what's new? (PubMed, Expert Rev Neurother) - "Seven antiseizure medications (ASMs) in the US (six in the UK/EU) are licensed for the treatment of seizures in LGS: lamotrigine, topiramate, rufinamide, clobazam, felbamate (not licensed in the UK/EU), cannabidiol and fenfluramine. Although no major breakthroughs have been reported, several established and novel ASMs, some surgical strategies and other treatment approaches are of benefit or are showing promise. Progress remains incremental but any improvements in the management of this resistant epilepsy syndrome are worthwhile."

Journal • CNS Disorders • Epilepsy

Refining management strategies for Lennox-Gastaut syndrome: Updated algorithms and practical approaches. (PubMed, Epilepsia Open) - "If this is ineffective as monotherapy, adjunctive therapy with, firstly, lamotrigine and secondly, rufinamide, is recommended. If seizure control remains suboptimal, subsequent adjunctive ASM treatment options include (alphabetically) cannabidiol, clobazam, felbamate, fenfluramine, and topiramate, although evidence for these is more limited...Most people with LGS have learning difficulties and need a lot of support, often in residential care. The authors are experts in treating people with LGS and this article provides up-to-date guidance and advice on how best to care for those with the condition."

Journal • CNS Disorders • Epilepsy