Anticonvulsant

• Atogepant (brand name: Aquipta) was recently recommended by the National Institute for Health and Care Excellence (Nice) to prevent episodic and chronic migraine attacks.
• The drug would be recommended to people who have at least four migraine days a month or where at least three previous preventative treatments have failed.
• Migraine is a complex neurological condition that affects about 10 million people in the UK.
• It’s characterised by recurrent, severe headaches that can be made worse by physical activity and are often debilitating.
• However, it’s only suited to patients who suffer from episodic migraines – whereas atogepant can be used by people who have both chronic and episodic migraines.

Consistently effective

Three clinical trials have shown atogepant to be safe and effective for people with episodic or chronic migraines.

• The Advance trial evaluated how safe and effective different doses of atogepant were compared with a placebo in preventing episodic migraine.
• The 60mg once-daily tablet was found to be well tolerated and effective, leading to nearly seven fewer migraine days per month.
• A third trial, the 302-LTS trial, followed participants who suffered from episodic migraine for over a year, finding that atogepant was consistently effective for reducing migraine attacks.
• Atogenpant was consistently shown to be safe across all studies, including the one that lasted for a year.

Anna Andreou receives funding from the Medical Research Foundation and Brain Research UK. She also received research funding from eNeura, AbbVie and Pfizer. She is affiliated with the International Headache Society, being elected as a Trustee of the Board. She is Chair of the Headache special interest group of the British Pain Society.

• But experiencing a seizure does not always mean a person has epilepsy.
• Seizures can be provoked by acute head injuries, alcohol withdrawal and high blood sugar, among other things.

What does a seizure look like?

• For some people, their seizure is a purely internal sensation.
• In fact, most people with epilepsy have only relatively subtle, nonconvulsive seizures at first, then develop convulsive seizures over time.
• This is the type of seizure most of us are familiar with, probably because it’s the kind most frequently depicted, though not always accurately, in movies and on television.
• The most common type of epileptic seizure are those that are focal – that is, they arise from a confined region of the brain.

What causes a seizure to occur?

Seizures are the result of abnormal electrical activity in the brain. The bursts of activity disrupt normal functioning and initiate hyperactivity in the affected brain area, which then can affect the corresponding body part. For instance, if the seizure arises from the part of the brain involved in arm movement, that arm will experience involuntary hyperactivity.

If you’re a bystander, how can you help?

• Many seizure-related injuries occur due to falling or coming in contact with sharp or hard objects.
• If they begin to fall, help them to the floor as gently as possible and put something soft under their head.
• During the convulsive phase of a seizure, breathing may be intermittent.
• So turn the person on their side so they can breathe more easily and lower the risk of aspiration.
• Following the seizure, and as the person gradually recovers and wakes up, help them sit up in a safe space.

Are new treatments available?

• People with epilepsy, particularly those who experience frequent seizures, will often have emergency medications in their possession.
• The most common emergency medications – also called seizure rescue medications – are a type of anticonvulsants called benzodiazepines.
• Patients and their caretakers may have access to rescue medications and know how to use them.

What if it’s not a seizure?

If a bystander does not witness a seizure, but instead finds someone unresponsive or minimally responsive, call 911. They may be suffering from other medical issues, such as a drug overdose. And if you are interested in training and certification for seizure first aid, or if you simply want to know more, the Epilepsy Foundation has more information.

• Jacob Pellinen has received research support from the Department of Neurology at the University of Colorado School of Medicine, the Colorado Clinical and Translational Sciences Institute, NIH/NINDS, and the American Epilepsy Society.
• J. Pellinen serves as chair of the professional advisory board for the Epilepsy Foundation of Colorado and Wyoming (unpaid), serves as the Epilepsy Section Editor for Current Neurology and Neuroscience Reports, and has received compensation for serving on the scientific advisory board for SK Life Science.

• Several biopharma companies are developing psychedelics-based treatments for various mental health conditions like Generalized Anxiety Disorder (GAD).
• It continued: "DelveInsight's analyst projects that among the total diagnosed prevalent cases of Generalized Anxiety Disorder (GAD) in 7MM approximately 53% of cases were from the US.
• The Generalized Anxiety Disorder (GAD) market is projected to witness consistent growth throughout the forecast period (2023–2032).
• The market size of Generalized Anxiety Disorder (GAD) in the 7MM is expected to increase, driven by better diagnosis and the launch of emerging therapies."

Human medicines European public assessment report (EPAR): Lyrica, pregabalin, Date of authorisation: 05/07/2004, Revision: 62, Status: Authorised