Herbs for Epilepsy!Highlights of the 2005 Joint Meeting of the American Epilepsy Society and the American Clinical Neurophysiology Society, December 2-6, 2005; Washington, DC The American Epilepsy Society (AES) and the American Clinical Neurophysiology Society (ACNS) held their joint annual meeting in Washington, DC, December 2-6, 2005. Clinicians and scientists came together to share the latest research data in epilepsy and neurophysiology. Abstracts based on these presentations were published in the 2005 issue of Epilepsia Volume 46, Supplement 8.
Herbs and Botanicals One of the new special interest group meetings this year was herbs and botanicals (ie, Botanicals as Anticonvulsant Therapy), coordinated by Steven Schachter, MD, Professor of Neurology, Harvard Medical School Osher Institute, Boston, Massachusetts. Dr. Schachter introduced the concept that herbs and botanicals may represent an economical and effective resource for modern epilepsy treatment. Natural products are contained in more than half of the best-selling US prescription drugs, such as aspirin (willow bark), digitalis (foxglove), galantamine (daffodil bulbs), and paclitaxel (Pacific yew tree bark). Over 100 drugs have been studied in the Far East for the treatment of epilepsy. More than 70% of people with epilepsy use herbs for their general health, and some try to treat their epilepsy with natural products. Nicholas Sucher, MD, Children's Hospital and Harvard Medical School, Boston, described his basic science research in traditional Chinese medicine (TCM) treatments for stroke and epilepsy. Dr. Sucher explained the 4 major components of a TCM prescription: Jun ("Ruler") attacks the main cause or disease symptom; Chen ("Minister") is directed at the underlying cause, symptoms, and complications; Zuo ("Assistant") treats secondary symptoms and counteracts potential adverse effects of the primary drugs; and Shi ("Enabler") directs the action of all the other drugs into the correct channels. Each formulation contains a combination of approximately 7 drugs, which must be specially prepared by soaking and boiling. One TCM prescription, "Tian Ma Gou Teng Yin," which is prescribed to "calm excessive endogenous wind," contains 11 different drugs and is used for seizures, stroke, and hypertension. Dr. Sucher's studies revealed multiple mechanisms of action, including NMDA antagonism with a non-magnesium-type block, blockade of caspase-8 (an enzyme involved in programmed cell death), and neuroprotective properties. Dr. Sucher suggested that herbal medicines act with low affinity at multiple targets and may be more effective when used in combination. Siegward-M. Elsas, MD, Assistant Professor of Neurology, Oregon Health and Science University, Portland, Oregon, noted that herbal epilepsy treatments are found throughout the world in native cultures. These include Ayurvedic medicine (Withania somnifera), the Pacific Islands (kava [Piper methysticum]), TCM (Piper nigrum, Cynanchum otophyllum), native North and South America (Passiflora incarnata), and Europe (valerian). Dr. Elsas observed that these compounds possess biochemical activity that warrants further research. For example, valepotriates from valerian inhibit gamma-aminobutyric acid (GABA) metabolism and may bind to GABA receptors. Passiflora incarnata enhances GABAA receptor ligand binding and is a partial GABAA agonist, inhibiting pentylenetetrazol-induced seizures in rodents. Kava enhances GABAA receptor ligand binding, inhibits voltage-gated Na+ and Ca++ channels, and inhibits strychnine-induced seizures in rodents. Of importance, Dr. Elsas stated that botanicals are not without health risks. For example, kava may cause liver toxicity and ephedra and Ginko biloba may precipitate seizures. Dr. Elsas recommended that formal clinical trials need to be conducted to further investigate the use of herbs and botanicals in the treatment of epilepsy, and that compounds should elicit at least a 50% responder rate in order to qualify for further study. Gou Teng has long been used to help with convulsions in Chinese medicine. It was first recorded for use in AD 500. Stems and thorns are collected in winter. It is a sedative and antispasmodic and is mainly used for easing tremors, siezures, spasms, headaches and dizzyness. It is also used by the Chinese to reduce high blood pressure. It must only be taken under medical supervision. Passiflora incarnata (passionflower) mentioned above has valuable sedative and tranquillizing powers. It is a well known remedy for sleeplessness and for stress. It also has painkilling properties. It is often used for treating palpitations, asthma, high blood pressure and muscle cramps. There are many species of passiflora, quite a few of them have similar properties. Valerian is another herb widely used in Europe to help with stress and anxiety, which can often trigger convulsions and seizures. It has a long record of use for epilepsy. Withania is an Ayurveda herb, used for easing stress and anaemia. Much research has been done in India on Withania to justify it’s strong reputation. It is also a very good restorative tonic. Powdered root is generally used as a calming tonic. The leaves contain withanolides, which inhibits cancer cell growth.
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