Neurotech InsightsTM (October 1, 2013) notes: “Patients would therefore be able to self-administer anticonvulsant therapy when they feel the onset of a seizure, as signaled by aura, or potentially during status epilepticus."
EpaleX is devoted to the development of novel breakthrough treatments to improve the quality of life for people with epilepsy or migraine. The products are designed for self-administration by patients who experience seizure aura; for administration by a family member, caregiver or bystander to provide rapid treatment of status epilepticus; and for self-administration at onset of migraine.
EpaleX is advancing a range of molecules and delivery systems. Propofol hemisuccinate, an EpaleX lead molecule, is a prodrug for propofol, which has unique activity in the treatment of intractable migraine as documented in the following publications:
Krusz JC, Scott V, Belanger J. Intravenous propofol: unique effectiveness in treating intractable migraine. Headache 2000;40:224–230.
Mendes PM, Silberstein SD, Young WB, Rozen TD, Paolone MF. Intravenous propofol in the treatment of refractory headache. Headache 2002;42:638–641.
Bloomstone JA. Propofol: a novel treatment for breaking migraine headache. Anesthesiology 2007;106:405–406 .
Sheridan DC, Spiro DM, Nguyen T, Koch TK, Meckler GD. Low-dose propofol for the abortive treatment of pediatric migraine in the emergency department. Pediatr Emerg Care 2012 ;28:1293–1296.
Soleimanpour H, Ghafouri RR, Taheraghdam A, Aghamohammadi D, Negargar S, Golzari SE, Abbasnezhad M. Effectiveness of intravenous dexamethasone versus propofol for pain relief in the migraine headache: a prospective double blind randomized clinical trial. BMC Neurol 2012;12:114.
Mohseni M, Fatehi F. Propofol alleviates intractable migraine headache: a case report. Anesth Pain Med 2012;2:94–96.
Soleimanpour H, Taheraghdam A, Ghafouri RR, Taghizadieh A, Marjany K, Soleimanpour M. Improvement of refractory migraine headache by propofol: case series. Int J Emerg Med 2012 ;5:19.
Mosier J, Roper G, Hays D, Guisto J. Sedative dosing of propofol for treatment of migraine headache in the emergency department: a case series. West J Emerg Med 2013;14:646–649.
Ward DI, Mulcahy R, Bailey P, Morgan D. Use of intravenous propofol in the treatment of migraine headache. Emerg Med Australas.2013;25:619.
Razavi S, Gharaei B, Jafari A, Aghamohammadi H, Mirkheshti A. Propofol and alfentanil in treatment of a patient with episodic cluster headache. Anesth Pain Med 2014;4:e17560.
Moshtaghion H, Heiranizadeh N, Rahimdel A, Esmaeili A, Hashemian H, Hekmatimoghaddam S. The efficacy of propofol vs. subcutaneous sumatriptan for treatment of acute migraine headaches in the emergency department: A double-blinded clinical trial. Pain Pract. 2014 Jul 12. doi: 10.1111/papr.12230. PubMed PMID: 25040321.
The preclinical basis for propofol hemisuccinate in migraine is investigated in the following publication:
Dhir A, Lossin C, Rogawski MA. Propofol hemisuccinate suppresses cortical spreading depression. Neurosci Lett 2012;514:67–70.
The preclinical basis for propofol hemisuccinate in epilepsy is investigated in the following publication:
Dhir A, Zolkowska D, Murphy RB, Rogawski MA. Seizure protection by intrapulmonary delivery of propofol hemisuccinate. J Pharmacol Exp Ther 2011;336:215–222.
The research programs of EpaleX have been supported by the University of California, Davis; the Epilepsy Therapy Project; the Epilepsy Foundation of America; and the National Institutes of Health through the National Center for Advancing Translational Sciences.
The EpaleX lead program is the subject of one of the original BrIDGs (Bridging Interventional Development Gaps) awards of NIH's National Center for Advancing Translational Sciences (NCATS), representing a partnership between EpaleX and UC Davis. Further information is available from NCATS.