Research carried out by a team from the Centre for Biomedical Sciences, Royal Holloway, University of London, and published today in Epilepsia, may have identified a new way to help patients with epilepsy by combining a high-fat diet with low doses of an epilepsy drug.
Combining diet with low doses of an epilepsy drug.
It has long been recognised that some epilepsy patients, particularly children, can benefit from a high fat, low carbohydrate ‘ketogenic’ diet, where the activity of the diet was thought to be through the production of chemicals called ‘ketones’.
However, recent work led by Professor Robin Williams, from Royal Holloway’s Centre for Biomedical Sciences, suggest that it is fatty acids provided in the diet that block seizures, by inhibiting specific receptors in the brain.
In a collaboration with Professor Matthew Walker at the Institute of Neurology, University College London, and Dr Philip Chen also from Royal Holloway’s Centre for Biomedical Sciences, the team suggested that the diet could be combined with the drug Perampanel which is used to help reduce epileptic seizures by acting on the same receptors.
Professor Williams said: “The drug can have serious side effects and doesn’t work for all patients. Our research however, suggests that combining a lower dose of the drug with a high-fat diet may benefit some sufferers, and reduce the risk of side-effects”.
Professor Walker said: “In the past people have tried to understand how the ketones impacted on the epilepsy. Our work shows that fatty acids are likely to provide control of seizures, and combining dietary fatty acids and perampanel is likely to work in epilepsy treatment.”
Dr Chen said: “This provides an unusual example of drug and dietary therapy acting together. What we are seeing here is more complicated than simply taking a drug. It is about reducing the level of the drug required and combining it with a very specific diet”.
“The next step is to move towards clinical studies, to show this improvement in treatment in patients” Professor Williams added.
There are around 600,000 people with epilepsy in the UK and 1 in 220 children are diagnosed with the condition. Around 30 per cent of sufferers continue to have seizures despite treatment, so this work offers a potentially exciting advance in finding new treatments.
The full title of the paper is: Perampanel and decanoic acid show synergistic action against AMPA receptors and seizures
The paper will be published in Epilepsia
DOI: 10.1111/epi.14578
