司替戊醇治疗癫痫的作用机制与疗效分析

Introduction: Stiripentol (STP) is an anti-epileptic drug used to treat Dravet syndrome (DS). Stiripentol can significantly reduce the frequency and severity of epileptic seizures in DS patients, improve the patient's quality of life, reduce the occurrence of status epilepticus, and have a positive impact on patients and their families. In addition, the safety and effectiveness of stiripentol in long-term use have also been confirmed.

The mechanism of action of stiripentol in the treatment of epilepsy

Stipentol mainly exerts anti-epileptic effects by directly acting on GABA-A receptors and enhancing GABAergic nerve conduction. GABA is an inhibitory neurotransmitter in the central nervous system, and activation of its receptors can reduce nerve excitability. Stipentol also inhibits multiple hepatic cytochrome P450 enzymes, which results in increased blood levels of other antiepileptic drugs (such as clobazam) and their active metabolites used in combination with it, thereby enhancing the antiepileptic effects of these drugs. Stipentol at clinical doses can enhance central GABA neurotransmission through a barbiturate-like effect, increase the duration of GABA-A receptor channel opening in hippocampal slices, and increase GABA levels in brain tissue by interfering with GABA reuptake and metabolism.

Efficacy analysis of stiripentol

In two studies, patients with Dravet syndrome who took stiripentol experienced significantly fewer clonic or tonic-clonic seizures than those who took placebo. About 74% of patients had a 50% or greater reduction in seizures during the second month of the study compared with before treatment. More than half of the patients experienced a 75% or greater reduction in seizures, and nearly 39% were seizure-free during the two-month study period.

Dosage Information

The recommended dose for adults is 25 mg/kg twice a day, or 16.67 mg/kg three times a day. The maximum dose is 3000mg/day. There are no clinical data to support this drug as monotherapy for Dravet syndrome. Recommended doses for children need to be analyzed based on age and weight. The recommended dose for children 6 months to less than 1 year old weighing at least 7 kg is 25 mg/kg twice daily. For children 1 year and older, weighing less than 7-10 kg, the dose is 25 mg/kg, taken orally twice daily. The recommended dose for persons weighing at least 10 kg is 25 mg/kg, taken twice daily, or 16.67 mg/kg, taken three times daily.