Has anyone on the list taken this medicine and if so, what were the results???
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Drug helps spinal cord injury patients
TORONTO, Sep 28 (Reuters) -- Encouraging results have been observed
following a 3-month trial of the drug 4-aminopyridine, a potassium channel
blocker, in patients with long-standing spinal cord injury.
It is among the few beneficial effects of drug therapy in long-standing
spinal cord injured patients reported, Dr. Jack Segal of the Veteran's
Affairs Medical Center, Long Beach, California, said at the joint meeting
of the American College of Clinical Pharmacology, the Canadian Society of
Clinical Pharmacology, and the Royal College of Physicians and Surgeons of
Canada.
Segal reported that on average, patients regained at least 1 to 1.5
neurological levels of function after 3 months of treatment with 30
milligram per day doses of 4-aminopyridine. Control patients on low-doses
(6 mg/day) of the drug showed no significant improvement in any of the
primary or secondary outcomes over the same study period, he added.
Following injury to the spinal cord, many of the nerves at the site of the
injury lose their protective, myelin sheath. This interferes with the
conduction of nerve impulses across the damaged areas. The drug
4-aminopyridine is thought to be capable of helping impulses cross
demylinated nerves, thus restoring some function.
The study involved 21 patients, all with spinal cord injuries of at least 2
or more years duration. Of these, 14 were quadriplegic, with paralysis
affecting all four limbs, and seven were paraplegic, with paralysis
affecting the lower limbs.
Sixteen patients received full-dose (30 mg/day) 4-aminopyridine, while six
patients received 6 mg/day 4-aminopyridine and served as controls.
The investigators looked at the patients' composite motor scores as well
as tests of sensation. Both measures increased significantly after 3 months
in the 30 mg/day group relative to baseline.
"This improvement translated not only into scores that we could quantitate,
but there were significant changes in patients' ability to carry out
activities of daily living," Segal said. For example, some patients became
able to independently transfer from wheelchair to bed. Others reported
enhanced sexual function and some patients recovered bowel and bladder
function, Segal noted.
A significant improvement was also seen in spasticity, increased muscle
tone and uncontrolled spasms, which is a common problem in spinal
cord-injured patients. Spasticity frequently manifests as painful muscle
spasm, especially at night. "As a result, some patients who hadn't had a
full night's sleep for years reported significant improvement in sleep,"
Segal said.
Equally, if not more importantly, he said, 4-aminopyridine improved
pulmonary function by 30% to 40%. Since pulmonary infections are a frequent
cause of morbidity and death in the spinal cord patient, the ability of
4-aminopyridine to strengthen respiratory muscles and the diaphragm, and to
improve the patient's ability to breathe, cough and clear secretions
could directly translate into a reduced susceptibility to pulmonary
infections, Segal said.
He warned that 4-aminopyridine is contraindicated in acute spinal cord
injury because it carries an increased risk of seizure in the acute injury
setting. However, Segal said that the drug can be considered in patients
whose injuries are a year or more in duration. Taken with meals, the drug
is also reasonably well tolerated, he added, with no serious adverse events
observed in the study group of patients over the 3-month trial.
Segal also noted that longer-term treatment with 4-aminopyridine, which
many of the patients in this initial study have remained on, may continue
to enhance sensory and motor function. In his experience, patients who
continue with treatment go through interludes where they suddenly gain
additional, noticeable improvement in function, which are followed by
plateaus. This phenomenon suggests that patients with long-standing spinal
cord injuries may continue to improve with longer term use of
4-aminopyridine, he commented.