Chronotherapy in the treatment of epilepsy

Chronotherapy in the treatment of epilepsy David A Stanley,1 Sachin S Talathi,2 Paul R Carney3 1Department of Mathematics and Statistics, Boston University, Boston, MA, USA; 2Qualcomm Research Center, San Diego, CA, USA; 3Departments of Pediatrics, Neurology, Neuroscience, and Biomedical Engineering, University of Florida, Gainesville, FL, USA Abstract: The presence of natural 24-hour oscillations within the body provides often overlooked opportunities for treatment of epilepsy. By simply tailoring the drug regimen to an individual's circadian rhythm, recent studies suggest one can improve the effectiveness of antiepileptic drugs, while reducing side effects. Daily variations in seizure occurrence and drug side effects create optimal timing windows for delivery of medication. Conversely, in certain epilepsy syndromes, there is growing evidence that both sleep and circadian rhythm can be distorted or misaligned. Thus, therapeutic re-entrainment of rhythms via application of zeitgebers (chronobiotics) may represent an untapped opportunity for improving patient quality of life. Keywords: circadian, epilepsy, sleep, chronotherapy, chronopharmacology, personalized medicine