Herbal Treatments for Epilepsy Lecture

[Guest guest]

Hi Health Conscious Consumers and Friends,

Yesterday,June 16,2009, a Lecture was held at NYU Medical Center on

Herbal Treatment for Epilepsy. The lecture was rather disappointing. It was

presented by Dr.Siddartha Nadkrani,MD. For a full rebuttal and explanation of

his overly pessimistic warnings and concerns see my discussion of these

towards the end of my summary. I know you want to hear something positive

about herbs, before I enter into a politically freighted dispute of his

assumptions about dietary supplements in general and herbs in particular.

 

My reply to his assertions are addressed at the end of this summary, but

at the outset I will try to give you some constructive advice on herbal

treatments, which you are more interested in.

Most of his presentation was taken from from the presentation of Dr.Orrin

Devinsky,MD head of the Comprehensive Epilepsy Center at NYU and also

skeptical of dietary supplements including herbs. A link to most of the slides

presented is found below:

_http://faces.med.nyu.edufaces/u5/Alternative_Therapies.pdf_

(http://faces.med.nyu.edufaces/u5/Alternative_Therapies.pdf)

The other slides that he presented are not up on the Faces web site yet,

but he said they would be soon.

Most of the information presented is a review of some of the medical

literature. I asked Dr.Nadkarni if he had ever prescribed an herbal treatment to

a patient, and if so what was the result?

He replied that he had NOT. But when patients took herbal medicines on

their own, he did not see any improvement or harm. So much for his expertise in

the area he was talking about.

 

He did cite a study using The Chinese Herb Qingyangsen roots which showed

improvement in 9 of 32 patients or 28% positive.

Zhengingling showed a 35% improvement in seizure reduction.

 

Dr.Nadkarni did mention an interesting case of a patient whose father cured

his epilepsy using Marijuana, which is not legal in New York, so she

wanted to know if she should move to Canada. There is some support in the

literature, but most studies talk more about its prevalence and patients

attitudes, not hard studies.

 

Although not an herb, melatonin, a hormone available as a dietary

supplement was mentioned as a possibly useful addition, especially if you

seizures

are sleep related.

You can start at 1mg and work up. This was covered more extensively by

Dr.LaJoie at the Alternative Treatments conference of 2003, see message #10533

in the epilepsycured archives:

_/messages/epilepsycured_

(/messages/epilepsycured)

 

There appears to be some reports of Benefit from Kampo (japanese herbal

medicine) TJ-960 (SK) " shosaiko-to-go-keishka-shyakuyaku-to " a mixture of 9

herbal drugs

The ultimate advice was that herbs might just as easily exacerbate seizures

as control them, proceed at your own risk!

Some Research I did on Medline searches and reviewing some literature I

have on Herbs follows:

 

Valerian Root may have an anticonvulsive effect, In my medline search I

found an article in Epilepsia 2004 Nov;45(11):1338 it is reported that in 1592

Pablo Colonna in his classic Phytobosanos, reported taking powdered

valerian root to cure his epilepsy, subsequent reports appeared of this

confirmed

it.In the 18th and 19th century it was often regarded as best available

treatment. Valerian yields substances similar to Valporic acid.

 

Skullcap is reported to be a relaxant in Chinese studies in Herbs that Heal

by Michael Weiner,PhD

 

Kava Kava has a sedative to tranquilizing effect according to Weiner

above.

 

A more positive and useful presentation on Herbal Treatments for Epilepsy

was presented by Dr. Daniel Luciano,MD at the Alternative Therapies

Conference at NYU Medical Center held in 2001, my Summary of that conference

is

in message #3230 in the archives of epilepsycured.

 

I found a good study of the Chinese herb chaiihu-longu-mull-tang(TW970)

reported in the American Journal of ; 2002;30(2-3):339-46

In a study of 20 patients with refractory epilepsy and at least 4

seizures/month and another group with milder epilepsy having less than 4

seizures/month were compared to a control group of 20 healthy matched adults.

After 4

months the refractory group had a decrease in seizure frequency from

13.4+/-3.4 to 10.7+/-2.5/ seizures/ month, representing a 20% reduction in

seizure frequency. The milder epilepsy group did not have a statistically

significant change.

 

Another study dealing with both Chinese Herbs(not named) and Acupuncture in

the Cochrane Data Base Systems Review 2008 Oct 8;(4):CD005062 performed in

Hong Kong

searched the Cochrane Epilepsy Group's Specialized Register (March 2008)

and the Cochrane registry of Controlled Trials(Central)(The Cochrane Library

Issue #1,2008.

From this data they selected Randomized Controlled trials comparing

acupuncture with placebo or sham acupuncture, which is sticking a needle into an

area that is not one of the meridians in real acupuncture, AED medication,

or no treatment; or comparing acupuncture plus other treatment with the

same other treatment.

They accepted 11 small trials involving a total of 914 patients in what

were termed generally poor methodological quality and with short follow up for

inclusion in the analysis. ten trials were carried out in China and one in

Norway.

Two trials found that more children treated with acupuncture and Chinese

herbs achieved a 75% or greater reduction in seizure frequency and a 50% or

greater reduction in seizure duration compared with Chinese herbs alone.

However, after combining the results of four trials that compared the

treatment group with a control group that could yield the net effect of needle

acupuncture alone, the researchers found no significant difference between

the treatment group and the control group in seizure frequency.

Compared to phenytoin (dilantin), the results in two trials showed that

patients who received needle acupuncture were more likely to achieve 75% or

greater reduction seizure frequency.

Compared to valporate(Depakene/Depacote), the results of 3 trials showed

that catgut implantation at acupoints appeared more likely to result in 75%

or greater reduction in seizure frequency.

After all this positive evidence of acupuncture's substantial benefit, the

authors come to the AMAZING conclusion that the " evidence does NOT support

acupuncture as a treatment for epilepsy " --go figure.

 

Patients might be interested in seeing a doctor who specializes in

Acupuncture and Traditional (TCM). A presentation on

Traditional

and Acupuncture was made at the Alternative Therapies for

Epilepsy Conference at NYU in 2001 by Dr,Shobai Wang,MD of New York City. A

full description of his talk begins on Friday Morning of my summary of

that conference. See message #3230 in the archives of epilepsycured.

 

If you do an internet search on Traditional you might be

able to find a practitioner near you. You should ask the practitioner for

his or her credentials and training in the field.

 

 

 

From the outset Dr.Nadkarni decreased expectations and spent more time

warning patients of the possible dangers presented by use of " unproven " natural

treatments that have not been approved by medical authorities such as the

Food & Drug Administration(FDA).

 

..

 

He stated his bias toward western drug therapy at the outset and felt this

at least should show that he was open minded.

 

Actually he misstated the function and actual performance of the FDA in

the regulation of both prescription drugs and dietary supplements, which

include herbs.

He even stated that if these herbal treatments worked we would not be

talking about it at a lecture, but a major drug company would be selling it.

This is absolutely FALSE. An herbal treatment could not be patented by a

drug company. The herb is in the public domain and no drug company can obtain a

monopoly on its sale, once clinical trials have been approved. Therefore

no drug company would lay out the million dollar cost of obtaining drug

approval in order to bring it to market.

 

The FDA does not test any drugs. They only approve a clinical trial

submitted to them by a drug company. The adverse side effects listed in the

Clinical trial and available in the Physicians Desk Reference is made for the

purpose of limiting the liability of the drug company if a patient suffers an

adverse reaction and the patient or his estate tries to sue the drug

company. The drug company can then successfully assert that " we told you and

your doctor it could cause that problem. "

 

As to the history of the Dietary Supplement Health Education Act of 1994,

the FDA never took the position that it did not want to regulate dietary

supplements. It was the largest outpouring of consumer mail and contact to

legislators that forced the FDA not require prior approval of dietary

supplements and to allow supplement manufacturers to make " structure and

function "

claims that are supported in the medical or scientific literature. The

FDA did not allow supplement manufacturers from making these claims.This

reading and interpretation of the law has been affirmed by the US court of

Appeals for the Washington,DC circuit, the next highest court in the United

States, below the Supreme Court in the Case of Pearson v.Shalala decided in

1999.The court stated:

 

[FDA's] argument runs along the following lines: that health claims

lacking " significant scientific agreement " [which is no more than FDA

'opinion']

are inherently misleading because they have such an awesome impact on

consumers as to make it virtually impossible for them to exercise any judgment

at the point of sale....We think the contention is almost frivolous. We

reject it. ... [The] First Amendment directs us to be especially skeptical of

regulations that seek to keep people in the dark for what the government

perceives to be their own good.

 

FDA appealed and the Supreme Court refused to hear the appeal, so this case

is current law.

 

But what about those unknown dangers of herbs that Dr.Nadkarni warned

about?

In fact the American Association of Poison Control Centers publishes an

annual report of Poisoning events reported to them, including all substances

that are from prescription drugs, to household products and detergents, and

dietary supplements. These reports are on their website _www.aapcc.org_

(http://www.aapcc.org) This is a loose association and does not prove the

event was caused by the substance.

The last report on their website for 2007, shows that there was only 1

death from all herbs and Botanicals. That was attributed to a multibotanical

with ma huang (ephedra).

The total number of deaths associated with Anticonvulsant's was 12. All of

which were approved by the FDA.

Carbamazepine

(Tegretol/Epitol) 1

Phenytoin (Dilantin)

4

Valporic Acid(

Depakene/Depacote) 5

Other

2

Total

12

The numbers are similar for prior years.

This makes herbs look a lot safer than

anticonvulsant drugs.

Arnold

 

 

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