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Anticonvulsant Agents: Potassium Bromide

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NeuroPsychopharmacotherapy

Abstract

Potassium bromide (KBr) is the oldest anticonvulsant agent, and its efficacy had already been discovered in the nineteenth century. Today, it is available in only a few countries. When used in humans, KBr is mainly applied in severe childhood epilepsies with generalized tonic-clonic seizures like Dravet syndrome. Positive effects in children with malignant migrating seizures in infancy and PCDH-19 related epilepsy have been observed. KBr predominantly enhances GABA-ergic inhibition and its pharmacology is simple. The bioavailability is almost 100%, and there are no significant interactions except a competition against chloride in the body. The half-life time is age-dependent and varies with the intake of fluids and sodium chloride between 6 and 14 days. Usual daily doses of KBr range between 30 and 60 mg/kg/die. Typical side effects include cutaneous (halide acne, bromoderma tuberosum), gastrointestinal (gastritis, ulcer), and central nervous (sedation, bromism) symptoms.

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References

  • Caraballo R, Pasteris MC, Fortini PS, Portuondo E. Epilepsy of infancy with migrating focal seizures: six patients treated with bromide. Seizure. 2014;23:899–902.

    Article  Google Scholar 

  • Charalambous M, Shivapour SK, Brodbelt DC, Volk HA. Antiepileptic drugs’ tolerability and safety – a systematic review and meta-analysis of adverse effects in dogs. BMC Vet Res. 2016;12:79.

    Article  CAS  Google Scholar 

  • Ernst JP, Doose H, Baier WK. Bromides were effective in intractable epilepsy with generalized tonic-clonic seizures and onset in early childhood. Brain and Development. 1988;10:385–8.

    Article  CAS  Google Scholar 

  • Hayashi K, Ueshima S, Ouchida M, Mashimo T, Nishiki T, Sendo T, Serikawa T, Matsui H, Ohmori I. Therapy for hyperthermia-induced seizures in Scn1a mutant rats. Epilepsia. 2011;52:1010–7.

    Article  Google Scholar 

  • Higurashi N, Nakamura M, Sugai M, Ohfu M, Sakauchi M, Sugawara Y, Nakamura K, Kato M, Usui D, Mogami Y, Fujiwara Y, Ito T, Ikeda H, Imai K, Takahashi Y, Nukui M, Inoue T, Okazaki S, Kirino T, Tomonoh Y, Inoue T, Takano K, Shimakawa S, Hirose S. PCDH19-related female-limited epilepsy: further details regarding early clinical features and therapeutic efficacy. Epilepsy Res. 2013;106:191–9.

    Article  CAS  Google Scholar 

  • James LP, Farrar HC, Griebel ML, Bates SR. Bromism: intoxication from a rare anticonvulsant therapy. Pediatr Emerg Care. 1997;13:268–70.

    Article  CAS  Google Scholar 

  • Korinthenberg R, Burkart P, Woelfle C, Moenting JS, Ernst JP. Pharmacology, efficacy, and tolerability of potassium bromide in childhood epilepsy. J Child Neurol. 2007;22:414–8.

    Article  Google Scholar 

  • Locock C. In discussion of Sieveking E.H. Analysis of fifty-two cases of epilepsy observed by the author. Lancet. 1857;1:527.

    Google Scholar 

  • Lotte J, Haberlandt E, Neubauer B, Staudt M, Kluger GJ. Bromide in patients with SCN1A-mutations manifesting as Dravet syndrome. Neuropediatrics. 2012;43:17–21.

    Article  CAS  Google Scholar 

  • Lotte J, Bast T, Borusiak P, Coppola A, Cross JH, Dimova P, Fogarasi A, Graneß I, Guerrini R, Hjalgrim H, Keimer R, Korff CM, Kurlemann G, Leiz S, Linder-Lucht M, Loddenkemper T, Makowski C, Mühe C, Nicolai J, Nikanorova M, Pellacani S, Philip S, Ruf S, Sánchez Fernández I, Schlachter K, Striano P, Sukhudyan B, Valcheva D, Vermeulen RJ, Weisbrod T, Wilken B, Wolf P, Kluger G. Effectiveness of antiepileptic therapy in patients with PCDH19 mutations. Seizure. 2016;35:106–10.

    Article  Google Scholar 

  • Meierkord H, Grünig F, Gutschmidt U, Gutierrez R, Pfeiffer M, Draguhn A, Brückner C, Heinemann U. Sodium bromide: effects on different patterns of epileptiform activity, extracellular pH changes and GABAergic inhibition. Naunyn Schmiedeberg’s Arch Pharmacol. 2000;361:25–32.

    Article  CAS  Google Scholar 

  • Oguni H, Hayashi K, Oguni M, Mukahira A, Uehara T, Fukuyama Y, Umezu R, Izumi T, Hara M. Treatment of severe myoclonic epilepsy in infants with bromide and its borderline variant. Epilepsia. 1994;35:1140–5.

    Article  CAS  Google Scholar 

  • Palacios JM, Niehoff DL, Kuhar MJ. Ontogeny of GABA and benzodiazepine receptors: effects of Triton X-100, bromide and muscimol. Brain Res. 1979;179:390–5.

    Article  CAS  Google Scholar 

  • Saito Y, Sugai K, Nakagawa E, Sakuma H, Komaki H, Sasaki M, Maegaki Y, Ohno K, Sato N, Kaneko Y, Otsuki T. Treatment of epilepsy in severely disabled children with bilateral brain malformations. J Neurol Sci. 2009;277:37–49.

    Article  Google Scholar 

  • Schwieger-Briel A, Bast T, Technau-Hafsi K, Kern JS. Vegetating plaques in a patient with a 6 disorder. J Dtsch Dermatol Ges. 2015;13:585–6.

    PubMed  Google Scholar 

  • Steinhoff BJ, Kruse R. Bromide treatment of pharmaco-resistant epilepsies with generalized tonic-clonic seizures: a clinical study. Brain and Development. 1992;14:144–9.

    Article  CAS  Google Scholar 

  • Suzuki S, Kawakami K, Nakamura F, Nishimura S, Yagi K, Seino M. Bromide, in the therapeutic concentration, enhances GABA-activated currents in cultured neurons of rat cerebral cortex. Epilepsy Res. 1994;19:89–97.

    Article  CAS  Google Scholar 

  • Tanabe T, Awaya Y, Matsuishi T, Iyoda K, Nagai T, Kurihara M, Yamamoto K, Minagawa K, Maekawa K. Management of and prophylaxis against status epilepticus in children with severe myoclonic epilepsy in infancy (SMEI; Dravet syndrome) – a nationwide questionnaire survey in Japan. Brain and Development. 2008;30:629–35.

    Article  Google Scholar 

  • Vaiseman N, Koren G, Pencharz P. Pharmacokinetics of oral and intravenous bromide in normal volunteers. Clin Toxicol. 1986;24:403–13.

    CAS  Google Scholar 

  • Woody R. Bromide therapy for pediatric seizure disorder intractable to other antiepileptic drugs. J Child Neurol. 1990;5:65–57.

    Article  CAS  Google Scholar 

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Correspondence to Thomas Bast .

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Bast, T., Steinhoff, B.J. (2020). Anticonvulsant Agents: Potassium Bromide. In: Riederer, P., Laux, G., Mulsant, B., Le, W., Nagatsu, T. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_304-1

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  • DOI: https://doi.org/10.1007/978-3-319-56015-1_304-1

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