Translating Nature to Nurture: Back to the Future for "New" Epilepsy Therapies

An emerging strategy for finding new epilepsy therapies is focused on botanicals (as illustrated by recent attention to medical marijuana), given their centuries-old traditions of use in treatment of convulsive seizures, contemporary anecdotal reports of efficacy in persons with epilepsy, and identification of underlying mechanisms of action that are relevant to epilepsy. Hundreds of plant extracts have been found to block seizures in acute animal seizure models, with actions that include effects on GABA receptors and voltage-gated ion channels as well as anti-inflammatory and neuroprotective effects. While existing published clinical studies of botanicals and seizure control are generally of inadequate quality to determine safety and efficacy, recent developments at the FDA may encourage sponsors to develop and commercialize botanicals for epilepsy.