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Porphyria Educational Services

PORPHYRIA EDUCATIONAL SERVICES BULLETIN Vol.1 No.4 Jan. 1999
SEIZURE TREATMENT IN ACUTE PORPHYRIAS: Gabapentin aka Neurontin

Treatment of seizures in acute intermittent porphyria: safety
and efficacy of gabapentin.
Source: Seizure 1998 Oct;7(5):415-6

Zadra M, Grandi R, Erli LC, Mirabile D, Brambilla A

Divisione di Neurologia, Ospedale Bolognini, Seriate, Italy.

Treatment of seizures in acute intermittent porphyria represents a
therapeutic dilemma.

Patients needing chronic therapy often experience acute porphyric attacks
due to increased hepatic metabolism induced by the antiepileptic drugs themselves.
Gabapentin which is also known as Neurontin, is a new antiepileptic drug
Neurontin is not appreciably metabolized by the liver in humans, and it
appears to be safe and effective in the maintenance therapy of epilepsy in these
patients. We report a patient affected by partial and generalized seizures
in the course of acute intermittent porphyria, who was safely
and successfully treated with gabapentin.

Source: Seizure 1998 Oct;7(5):415-6

Treatment of seizures in acute intermittent porphyria: safety
and efficacy of gabapentin.

Zadra M, Grandi R, Erli LC, Mirabile D, Brambilla A

Divisione di Neurologia, Ospedale Bolognini, Seriate, Italy.

Treatment of seizures in acute intermittent porphyria represents a
therapeutic dilemma for medical care providers.
Porphyria patients needing chronic therapy often experience more
acute porphyric attacks due to increased hepatic metabolism induced by
the antiepileptic drugs themselves.

Gabapentin [generic name] is a new antiepileptic drug.
The brancd name for Gabapentin is Neurontin.

Neurontin is not appreciably metabolized by the liver in humans.
Because of this Neurontin appears to be safe and effective in the
maintenance therapy of epilepsy in those patients with porphria.
In studies completed on a patient affected by partial and generalized
seizures in the course of acute intermittent porphyria, who was safely
and successfully treated with gabapentin. There use of Neurontin was
quite successful.

It should be noted that patients when prescribed Neurontin, should not be
using a regiment of Magnesium. Such use of magenisum tends to
neutralize the seizure medication.

Neurontin does serve as a pain medication. Pain relief by those who
use Neurontin comes from the fact that the medication stops the
inflamatory of nerve endings which in turn cause pain.


SUBSTANCES TOXIC TO NERVES
Triggers for PN

The following is a list of substances toxic to nerves with possible
resulting
peripheral neuropathy.

Adriamycin - for cancer
Amiodarone - for irregular heart beat
Chloramphenicol - an antibiotic
Cis-platinum - for cancer
Dapsone - for chronic and rare skin diseases
Diphenylhydantion (dilantin) - for seizures and pain
Disulfiram (Antabuse) - for alcoholics
Ethionamide - for tuberculosis
Flagyl (Metronidazol) - for trichomonas infections
*This is included in some prescriptions prescribed for vaginal yeast.
Glutethimide (doriden) - a sleeping pill
Gold - for rheumatoid arthritis
Hydralazine (Apresoline) - for high blood pressure
Isoniazid (INH) - for tuberculosis
Lithium - for manic depression and headache prevention
Misomidazole - for cancer
Nitrofurantoin (Furadantin, Macrobid, Macrodantin)
*This is commonly prescribed for urinary tract infection or in
low dosage as a UTI preventative.
Nitrous Oxide - an anesthetic
Penicillamine - for rheumatoid arthritis
Perhexiline (Pexid) - for angina
Pyridoxine (Vitamin B6) - a vitamin
Suramin - for cancer
Taxol - for cancer
Vincristine - for cancer
Source: The CMTA Newsletter Vol. 12 No 3. April 1995:

This is another list of substances toxic to nerves.
Again this list can be possible triggers of Peripheral Neuropathy.
Interesting enough most of the drugs are all ready contradicated
for porphyria patients.
Adriamycin
Alcohol
Amiodarone
Chloramphenicol
Cisplatin
Dapsone
Diphenylhydantion (dilantin)
Disulfiram (Antabuse)
Glutethimide (doriden)
Gold
Hydralazine (Apresoline)
Isoniazid (INH)
Mega Dose of Vitamin A
Mega Dose of Vitamin D
Mega Dose of Vitamin B6 (Pyridoxine)
Metronidazole (Flagyl)
Nitrofurantoin (Furadantin, Macrobid, Macrodantin)
Nitrous Oxide (chronic repeated inhalation)
Penicillin (Large IV doses only)
Perhexiline (Pexid)
Taxol
Vincristine
*Commonly used for cancer chemoetherapy.
Lithium, Misomidazole and Zoloft can be used with

Source: The CMTA Report Vol. 12 No 2. Spring 1997: