Epileptogenesis, the gradual process that leads to
epilepsy after
brain injury or genetic mutations, is a complex network phenomenon, involving a variety of morphological, biochemical and functional brain alterations. Although risk factors for developing
epilepsy are known, there is currently no treatment available to prevent
epilepsy. We recently proposed a multitargeted, network-based approach to prevent epileptogenesis by rationally combining clinically available drugs and provided first proof-of-concept that this strategy is effective. Here we evaluated eight novel rationally chosen combinations of 14 drugs with mechanisms that target different epileptogenic processes. The combinations consisted of 2-4 different drugs per combination and were administered systemically over 5 days during the latent epileptogenic period in the intrahippocampal
kainate mouse model of acquired
temporal lobe epilepsy, starting 6 h after
kainate. Doses and dosing intervals were based on previous pharmacokinetic and tolerability studies in mice. The incidence and frequency of spontaneous electrographic and electroclinical
seizures were recorded by continuous (24/7) video linked EEG monitoring done for seven days at 4 and 12 weeks post-
kainate, i.e., long after termination of drug treatment. Compared to vehicle controls, the most effective
drug combination consisted of low doses of
levetiracetam,
atorvastatin and
ceftriaxone, which markedly reduced the incidence of electrographic
seizures (by 60%; p<0.05) and electroclinical
seizures (by 100%; p<0.05) recorded at 12 weeks after
kainate. This effect was lost when higher doses of the three drugs were administered, indicating a synergistic drug-drug interaction at the low doses. The potential mechanisms underlying this interaction are discussed. We have discovered a promising novel multitargeted combination treatment for modifying the development of acquired
epilepsy.