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29 November 2016

Could a once-a-fortnight epilepsy drug be just what the doctor will order?

A long-lasting pill that releases its medicine for two weeks after being swallowed, has the potential to revolutionise the treatment of conditions including epilepsy, say researchers.

Scientists in the US have developed a prototype for a long-acting pill which, in the future, could put an end to the need for numerous repeat doses on a daily basis.

However, Professor Philip Patsalos, head of Epilepsy Society's Therapeutic Drug Monitoring Unit, has sounded a note of caution.

'At the moment it can take many weeks to adjust a person's epilepsy medication so that they always have the right concentration of the drug in their blood to give them maximum seizure control,' he said. 'Therefore it could take many months to get the right dose with a long-acting pill and achieving optimum seizure control may be unacceptably delayed.'

Malaria drug

The prototype has been tested with a malaria drug called ivermectin by the Massachusetts Institute of Technology team. Now a US company, Lyndra is developing the technology further, focusing on epilepsy, neuropsychiatric disorders, HIV and diabetes.

Co-author of the research, Dr Giovanni Traverso, from Harvard Medical School in the US, said: 'We want to make it as easy as possible for people to take their medications over a sustained period of time.

'When patients have to remember to take a drug everyday or multiple times a day, we start to see less and less adherence to the regimen.

'Being able to swallow a capsule once a week or once a month could change the way we think about delivering medications."

Routine problems

Professor Patsalos agreed that people with epilepsy who have to take their medication two or three times a day are less adherent to their medication than those who only need to take their drugs once a day.

However he added: 'While the availability of an AED formulation that can be taken every two weeks or even monthly sounds attractive, adherence may be compromised because the medication may not be taken frequently enough to allow patients to get into a “routine”; and this may be particularly problematic with the elderly and others with memory issues.'

Star-shaped pill

The prototype pill has a unique star-shaped structure with six arms that can be folded inwards and encased in a smooth capsule.

Drug molecules are loaded into the arms. After the capsule is swallowed, stomach acid dissolves its outer layer allowing the arms to unfold and release their payload.

Once expanded, the "star" is large enough to stay in the stomach and resist being pushed further down the digestive tract. However, it is not so large that there is a risk of blockage. Eventually, the arms break off and the pieces are expelled naturally.

More information

Read more about epilepsy medication and find out about alternative forms of treatment.


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