Ketamine may change the game life-threatening seizure changes

In a significant development of epilepsy treatment, researchers at the University of Virginia are launching a $30 million clinical trial to investigate whether ketamine can save patients from severe epilepsy seizures in response to standard treatment.

The study, supported by an initial $9.3 million grant from the National Institutes of Health, aims to address the critical gap in the current status quo of ongoing epilepsy medical programs, a dangerous state in which, Seizures last for more than five minutes or occur quickly without recovery.

The trial, known as Kesett, a ketamine-additive therapy for the established status epilepsy therapy treatment trial, emerged at a critical period when current treatment proved effective for less than half of adult patients. According to current data, standard anticonvulsants successfully blocked severe seizures in only 47% of adults and 52% of children.

“We hope that adding ketamine to existing treatments will terminate the status of epilepsy in more patients,” said Dr. Jaideep Kapur, co-director of the UVA Brain Institute and epilepsyologist at UVA Health and School of Medicine. “We hope this is a Trials could improve treatment guidelines for patients with these dangerous seizures.”

The bet is particularly high for patients with status epilepsy. Without effective intervention, these prolonged seizures can lead to permanent brain damage or prove fatal. The current regimen relies on a class of drugs called benzodiazepines, but many patients’ resistance to these treatments makes the choice of medical professionals limited.

This new study is based on the groundbreaking work of UVA in the field before. Their earlier determined status epilepsy treatment trial (ESETT) provides the first definitive comparison of three commonly used drugs – Levetiracetam, Fosphenytoin and Valproate. The study shows that these drugs are roughly equal in effectiveness, but their success rates leave a lot of room for improvement.

Choosing ketamine for this test is not arbitrary. Although the drug has recently attracted public attention for various uses, it has a long safety record in emergency medicine. Its known anticonvulsive properties make it a promising candidate for the treatment of resistant epilepsy.

The Kessett trial will evaluate two different dose levels of ketamine (1 mg and 3 mg) as an additional treatment for existing therapies. The study design is particularly noteworthy because it incorporates pediatric patients, and researchers expect children aged 1-17 to account for about one-third of the trial participants.

Dr. Kapoor highlights the wide range of possible implications of the study: “Each year, up to 160,000 Americans suffer from status epilepsy, and this trial is expected to bring them new and improved treatments.”

The scope of the trial is ambitious and is planned to be studied at about 60 locations in a few years. This multicenter approach should provide strong data on the effectiveness of ketamine in different patient populations.

Funded by the National Institute of Neurological Diseases and Stroke (Grant No. UG3NS131532), the trial represents a collaborative effort between UVA’s Brain Institutes – UVA’s Brain Institute (an interdisciplinary program designed to address complex Neuroscience Challenge – Other leading medical institutions in the country.

This study offers new hope for thousands of patients who have not responded to current treatment for epilepsy. If successful, adding ketamine to a standard protocol may represent a significant advance in emergency epilepsy care, which may save lives and prevent long-term neurological damage in adults and children.