Methsuximide for complex partial seizures: efficacy, toxicity, clinical pharmacology, and drug interactions.

Abstract

Methsuximide (MSM; Celontin) was administered for 8 weeks to 26 patients with complex partial seizures (CPS) refractory to phenytoin and carbamazepine and phenobarbital or primidone. A 50% or greater reduction in CPS frequency was obtained in eight patients. MSM therapy was continued chronically in these eight patients, and five continued to have a 50% or greater reduction in CPS frequency after 3 to 34 months of follow-up. Drowsiness, gastrointestinal disturbance, hiccups, irritability, and headache were the common side effects of MSM. No serious toxicity occurred. N-desmethylmethsuximide was the principal substance detected in plasma and had the following pharmacokinetic values: accumulation half-life, 49.7 hours; time to steady state, 10.4 days; elimination half-life, 72.2 hours; therapeutic range of plasma concentration, 10 to 30 mg per liter. Plasma concentrations of phenytoin and phenobarbital derived from primidone rose significantly (p less than 0.05) after addition of MSM.

• Authors: T R Browne, R G Feldman, R A Buchanan, N C Allen, L Fawcett-Vickers, G K Szabo, G F Mattson, S E Norman, D J Greenblatt
• Journal: Neurology (Neurology) Vol. 33 Issue 4 Pg. 414-8 (Apr 1983) ISSN: 0028-3878 [Print] United States
• PMID: 6403891 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Succinimides
• methsuximide

Topics

• Adult
• Biopharmaceutics
• Brain (physiopathology)
• Drug Interactions
• Electroencephalography
• Epilepsies, Partial (drug therapy, physiopathology)
• Gastrointestinal Diseases (chemically induced)
• Half-Life
• Headache (chemically induced)
• Hiccup (chemically induced)
• Humans
• Sleep Stages
• Succinimides (adverse effects, pharmacology, therapeutic use)