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Sultiame
Sultiame (rINN, also known as sulthiame) is a sulfonamide and inhibitor of the enzyme carbonic anhydrase. It is used as an anticonvulsant.
==History==
Sultiame was first synthesised in the laboratories of Bayer AG in the mid 1950s and eventually launched as Ospolot in Europe and other markets the early 1960s. It never became a registered drug in the USA. The brand was transferred to Desitin GmbH in 1993 and is sold in several European countries, in Israel, Japan, and Australia.
Sultiame became established as a second-line drug for treatment of partial epilepsy in the 1960s and 1970s and was often used in combination with the established anticonvulsant phenytoin. Temporal lobe seizures appeared particularly responsive to sultiame. Doubts subsequently arose as to whether sultiame has intrinsic anticonvulsant properties. After discovering sultiame's ability to raise the blood levels of phenytoin,〔Hansen JM, Kristensen M, Skovsted L. ''Sulthiame (Ospolot) as inhibitor of diphenylhydantoin metabolism''. Epilepsia 1968;9:17-22. PMID 4386877〕 it was assumed that sultiame would only act in combination with phenytoin. This finding, together with the equivocal results of a study in the US,〔Green JR et al. ''Sulthiame: Evaluation as an anticonvulsant''. Epilepsia 1974;15:329-49. PMID 4386877〕 resulted in a quick decline of sultiame's use. It was only in 1988, that the German child neurologist Hermann Doose discovered its specific effects in benign focal epilepsies of childhood.〔Doose H et al. ''Benign partial epilepsy - treatment with sulthiame''. Dev Med Child Neurol 1988;30:683-4. PMID 2906619〕 Today, sulthiame is the drug of choice for benign focal epilepsies of childhood (such as benign rolandic epilepsy) in the German-speaking countries and Israel.〔Wohlrab G. (''Epilepsiebehandlung im Kindes- und Jugendalter: Kontinuität und Wandel''. ) Epileptologie 2003;20:25-30.〕 There is renewed interest in sultiame's other potential uses, e.g., in West syndrome〔Debus OM et al. ''Sulthiame in the primary therapy of West syndrome''. Epilepsia 2004;45:103-8. PMID 14738417〕 and other refractory epilepsies〔Koepp MJ et al. ''Sulthiame in adults with refractory epilepsy and learning disability: an open trial''. Epilepsy Res 2002;50:277-82. PMID 12200218〕
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