Herbs in epilepsy

In centuries past, herbal medicine was applied very widely; and many drugs used nowadays, is based on herbs.

As medicines that can be useful in epilepsy, was used Valerian, passionflower or passion flower ( Passiflora incarnate ) (native to North and South America), Kava Kava ( Piper methysticum pepper intoxicating, a plant of the family pepper, black pepper ( Piper nigrum method of traditional Chinese medicine), and Withania somnifera ( Withania somnifera ; synonyms: Physalis flexuosa . solnechnyiy physalis, winter cherry, Indian ginseng — a means of Ayurveda).

In the analysis of herbal medicine in the Renaissance herbals found 2.220 kinds of greens used in the context of treatment of epilepsy. However, pharmacological data obtained in vitro and/or in vivo less than 5% of these plants. Less than 7% of vegetable origin, used for the treatment of epilepsy included in the manuscript writings of Dioscorides “On medicinal substances” ( lat. De materia medica ) developed in the beginning of the VI century in Constantinople.

Be aware that randomized controlled trials assessing the effectiveness of medicinal herbs in epilepsy has not been conducted, and the effectiveness of this method is certainly not proven.

Epilepsy herbal medicine in any case should not serve as a replacement therapy, anti-epileptic drugs (AEDs) — AEDs and efficacy of herbs comparable, and herbs can only be used as an additional method in a patient receiving treatment with anti-epileptic drugs. Unlike medicinal plants, the efficacy of AEDs in epilepsy was confirmed by means of evidence-based medicine.

However, the use of medicinal herbs (including for treatment of any other diseases) in patients with epilepsy with great caution, as the interaction of herbs and antiepileptic drugs are hard to predict (especially as the exact composition of all ingredients included in a collection of medicinal herbs is not known). Herbs can interact with drugs in the intestine, in liver, in kidneys and in their area. The mechanisms of these interactions are currently poorly understood. But the best known mechanism of interaction due to potential influence of herbs on the liver enzymes (cytochrome P450) and P-glycoproteins. through which the metabolism of many AEDs. Usually it is for drugs with a narrow therapeutic window. The risk is higher when taking AEDs are inducers or inhibitors of liver enzymes and lower for the AEDs that are virtually not metabolized in the liver. Such interactions can lead to changes in the effectiveness of treatment antiepileptic drugs in connection with a change in the concentration of drugs in plasma, as well as to deterioration in tolerability.

For example, the common use of Hypericum ( St. John’s wort . Hypericum) for more than 2 weeks may result in a decrease in the concentration of carbamazepine in plasma. Interestingly, prolonged use of St. John’s wort may also reduce the effectiveness of oral contraceptives. Overall, St. John’s wort chronic administration may reduce an important pharmacokinetic parameter — the area under the curve “concentration-time” (AUC) for a range of drugs.

The use of St. John’s wort for more than 2 weeks may decrease the effectiveness of carbamazepine

Furthermore, it is known that some herbs have proconvulsive effect and can cause seizures and worsen them in patients with epilepsy. These include, for example, eucalyptus, fennel, hyssop, mint, rosemary, sage, Cossack juniper ( Juniperus sabina ), tansy, thuja, turpentine (turpentine is a viscous fluid emitted from coniferous trees, raw material for rosin, turpentine), wormwood.

Eucalyptus, fennel, hyssop, mint, rosemary, sage, Cossack juniper ( Juniperus sabina ), tansy, thuja, turpentine (turpentine) and mugwort can worsen the symptoms of epilepsy and to provoke epileptic seizures as oral ingestion and the use of essential oils (aromatherapy, massage)

Medicinal herbs have been used not only orally, but also when carrying out aromatherapy and massage (use of essential oils derived from herbs). Therefore, epilepsy patients should also avoid using essential oils extracted from medicinal herbs listed above. You must exercise special care when using these herbs (as well as charges containing these herbs).

Despite the fact that herbs are medicinal ingredients of natural origin (they are “natural”), it does not mean that they are “harmless” and “harmless”.

Due to the fact that some medicinal herbs may reduce the effectiveness of antiepileptic therapy and even provoke seizures, patients should be sure to inform your doctor about medicinal herbs used by them!

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