Epileptologist Gregory Krauss discusses the results of a study that showed the efficacy of sublingual lorazepam as a rescue treatment for prolonged or repetitive seizures. This new study found that it is an effective and inexpensive treatment that holds promise for stopping seizures.
Hi, I'm Greg Krauss. I'm a neurologist in the Department of Neurology at Johns Hopkins Hospital. I want to tell you about a new treatment uh for uh se acute seizures that uh we recently uh uh reviewed in a study. Um I'm an epilepsy specialist and about a quarter of the patients that we see who have uh recurring seizures, which is defined as epilepsy have problems with prolonged or repetitive seizures when they have seizures. Occasionally the seizure lasts longer than five minutes or they may have more than two or three seizures in a 24 hour period. These seizures often require trips to the er, and we found that if we provide rescue medicines, patients can often have successful treatment at home and not have to go to the emergency room. And so we did a study in 52 patients where we repurposed a drug called LORazepam Intensol um and had family members give the drug through a medicine dropper in the side of the mouth when people who were having prolonged seizures or repetitive seizures. And we found that this was very effective in, in interrupting seizures. So, of our 52 patients, two thirds, their seizures stopped very rapidly when they received this sublingual or side of the mouth, uh drop drops of medicine. So, uh the majority of patients did very well with this treatment and the treatment results were very comparable to a couple marketed drugs that are given through uh nasal routes or through a rectal administration. The advantage of of the LORazepam intensol is that it costs less than $1 a dose where the marketed drugs, the nasal and the rectal are often $350 a dose. So there's considerable cost savings with the LORazepam intensol. The only disadvantage of the Zappa intensol is that it has to be refrigerated. So when people are leaving their home or traveling, what we recommend is they just get a very small uh mini cool that has uh a cooled uh a a bottom and that can allow refrigeration people to transport the drug when people receive the drug. Oram is slightly sedating. All these benzodiazepines used for acute rescue treatment are sedating the sedation though with oram intensol was very modest and was never severe. And so it was much better to receive the treatment than not in order to interrupt seizures. So our study showed that the LORazepam intensol can be uh conveniently given by caregivers and used to interrupt uh prolonged or repetitive seizures and may help patients remain uh at home during seizure clusters, uh and may help them when they're traveling or away from medical care. Uh protect them from seizures. Thanks very much.