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Progabide
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Progabide (PGB) is the first antiepileptic molecule synthesized on a theoretical basis: the gamma-aminobutyric acid-(GABA)-ergic theory of epilepsy. It is a GABA-agonist which can cross the blood-brain barrier. Approved for marketing in France and in Italy, progabide (Gabrène®) is available in 300 and 600 mg tablets and in powdered form.
Treatment of Chronic Fatigue Syndrome
Published in Jay A. Goldstein, Chronic Fatigue Syndromes, 2020
The role of the ANS in human pathophysiology is expanding. I have alluded to cortical control of cardiovascular responsiveness, but there is a cerebellar component as well. State changes, such as sleep and wakefulness, modulate baroreceptor tone, probably by serotoninergic mechanisms. The raphe nuclei are involved in migraine headache patients, in whom there is an impairment of sympathetic outflow to the pupil on the affected side.57 Migraines are probably more common in CFS. Thermoreceptive neurons in the preoptic area have been shown to be sensitive to behavioral changes or baroreceptor mechanisms. In multiple system atrophy (MSA), glutamic acid decarboxylase (GAD), a marker for GABA, is decreased, especially in the dentate nucleus. GABA agonists, available in other countries, may therefore be useful.58 A new drug, DL-dops, may increase plasma norepinephrine levels, and somatostatin, which has been occasionally helpful in CFS treatment, ameliorates post-prandial hypotension. These may be employed in MSA. There are infectious causes of autonomic nerve damage, best known in Chagas’ disease, but increasingly recognized in AIDS, in which a significant decline in autonomic function is found. Patients with IBS have been noted to have generalized or patchy anhidrosis, evidence of sympathetic denervation. This finding accords well with the work of Mathias, who has found GnRH receptors in sympathetic ganglia which may be one site of action for Lupron in IBS.59 We have previously discussed the function of the ANS in immunomodulation.
GABA-Mediated Neural Transmission in Mechanisms of Cardiovascular Control by the NTS
Published in I. Robin A. Barraco, Nucleus of the Solitary Tract, 2019
Studies using indirect-acting GABA agonists have supported a role of endogenous GABA in this GABAergic pressor response. Like direct-acting GABA agonists, indirect-acting agonists such as GABA uptake blockers (e.g., nipecotic acid) increase arterial pressure when injected directly into the NTS.32,53 Similar responses are observed following injection of some drugs that inhibit GABA metabolism, but these responses seem to be due to other actions of these drugs.6,55,59
Free latissimus dorsi flap for upper extremity reconstruction in a 9-month-old
Published in Case Reports in Plastic Surgery and Hand Surgery, 2021
Ryan D. Wagner, Jacqueline S. Yang, Brittany E. Bryant, William C. Pederson, Shayan A. Izaddoost
In 2016 and 2017, the FDA released drug safety communications warning that surgeries in children younger than 3 years involving multiple or lengthy exposures to general anesthesia and sedative drugs could affect brain development. Furthermore, these warnings suggested sedation over 3 hours could be linked to long-term behavioral or learning deficits [5,6]. These conclusions were based primarily on animal studies that found widespread neuronal death after hours of prolonged NMDA inhibitor anesthesia usage [7,8]. Subsequent studies have shown that GABA agonists can also negatively impact neurodevelopment [9]. While this data in mice, rats, and non-human primates presents significant concerns for the field of pediatric anesthesia and surgery, the implications of these neurotoxic effects have not yet been clearly translated into human metrics [10,11]. With this new data, reconstructive surgeons have to be extremely diligent when planning large reconstructive procedures in the young pediatric population and always weigh the risks and benefits of early intervention.
Premenstrual syndrome as a risk factor for relapse in GHB dependent patients: a case series
Published in Journal of Substance Use, 2020
Rouhollah Qurishi, Marieke Arts-De Jong, Victor J. A. Buwalda, Linda Hartman, Cornelis A. J. De Jong
An association between PMS and depressive disorders has been documented (Halbreich & Endicott, 1985). Recently, the growth hormone response to the GABA B receptor agonist baclofen was reported to increase during the luteal phase of the menstrual cycle of normal women (O’Keane & Dinan, 1994). As opposed to other neurotransmitters, GABA agonists up-regulate GABAergic receptors, and depressive analogs are combined with low GABA levels and down-regulated GABA B receptors (Lloyd, Zivkovic, Scatton, Morselli, & Bartholini, 1989). Hence, it could be predicted that a greater reaction to baclofen is associated with higher GABA levels. Therefore, it was suggested that plasma GABA levels would increase from the follicular to the luteal phase of a normal female’s cycle and that females with PMDD would have lower plasma GABA levels, especially during the dysphoric, late luteal phase (Halbreich et al., 1996).
An analysis of the effects of using Zolpidem and an innovative multimodal interdisciplinary team approach in prolonged disorders of consciousness (PDOC)
Published in Brain Injury, 2019
Mark Delargy, Rebecca O’Connor, Alison McCann, Irene Galligan, Heather Cronin, Dee Gray, Caoimhe O’Toole
Zolpidem is a widely prescribed sedative, belonging to the group of drugs known as imidazopiridines. It is a highly selective non-benzodiazepine gamma-aminobutyric acid (GABA) agonist acting on the omega-1 site of the GABA-A receptor, and has a short half-life of 3 hours(13). Singh, McDonald, Dawson, Lewis, Pringle, Smith, Pentland (2008) (14) explained that following a brain injury, the brain attempts to reduce the amount of metabolism taking place in an effort to protect damaged neurons. This effect is mediated by GABA and may spread to other un-effected areas of the brain. Zolpidem may work to reverse this dormancy effect(14). Zolpidem was administered using the same dosage and methods as outlined by Whyte and Meyers (2009). (3) Zolpidem 10 mg was administered in liquid form via the feeding tube followed by a flush of water (90 mls). In contrast to the approach of Whyte and Meyers (2009), (3) who instructed the research observer to interact freely with the patients involved, the team in this current case report carried out eight structured interdisciplinary multi-sensory hierarchical protocols over an eight week period. Each weekly session took place within 30–60 min of Zolpidem administration (see Appendix 1)