Propranolol Action in Chronically Unstable Generalized Epilepsy

Chronically unstable generalized epilepsy (CUGE) is a disabling disease usually treated by ineffective association of drugs. Authors have devoted attention to calcium-dependent mechanisms of seizures. Calcium channel blockers have been used with success in the control of both experimental and clinical epilepsy. beta-Adrenergic blockers, such as propranolol hydrochloride (PR), had been described to be experimentally effective in the control of epilepsy in rats and chicks, due to its receptor-dependent calcium channel blocking and membrane-stabilizing actions. We used PR in this crossover, placebo-controlled, randomized trial. Twelve patients with CUGE were enrolled and treated for 15 days with treatment A (20--40 mg PR bid) and treatment B (20--40 mg placebo); the difference in the total number of seizures in the two periods of treatment was compared. Patients treated with PR showed a 32.9% reduction (p < 0.05) in epileptic manifestations. The authors concluded that PR may be an effective adjunct therapy in CUGE and other forms of generalized epilepsy.