Expert Review of Neurotherapeutics最新文献

Recent advances in the management of Lewy body dementia: evaluating progress and future directions. 路易体痴呆管理的最新进展：评估进展和未来方向。

IF 4.3 2区医学

Expert Review of Neurotherapeutics Pub Date : 2026-10-16 DOI: 10.1080/14737175.2026.2749652

Jennifer G Goldman, Kathryn Wyman, Joseph Pm Kane

{"title":"Recent advances in the management of Lewy body dementia: evaluating progress and future directions.","authors":"Jennifer G Goldman, Kathryn Wyman, Joseph Pm Kane","doi":"10.1080/14737175.2026.2749652","DOIUrl":"https://doi.org/10.1080/14737175.2026.2749652","url":null,"abstract":"Introduction: Lewy body dementia (LBD), encompassing dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), is progressive and heterogeneous in clinical presentation and underlying pathobiology. LBD substantially impacts patient function, independence, and quality of life. Current therapies are symptomatic, and disease-modifying therapies are not established. Advances in in vivo biomarkers provide an important window for early disease diagnosis and intervention.Areas covered: This review examines the complex spectrum of LBD, including DLB, PDD, and prodromal states of MCI-LB and PD-MCI. Advances in biomarkers and biological frameworks are considered along with limitations in DLB. Recent pharmacological and non-pharmacological clinical trials are highlighted. The authors offer commentary on the challenges and opportunities for current and future research and care in LBD.Expert opinion: LBD remains a diagnostic and therapeutic challenge. The development and validation of in vivo biomarkers of LBD permit improved and earlier diagnosis, along with deeper characterization of LBD. Further research is needed to harmonize and implement biological frameworks and staging, develop and validate biomarkers and LBD-relevant clinical outcome measures, and design clinical trials using biologically based agents for disease-modification. Lastly, creating holistic care plans that span the entire disease is essential for improving patient outcomes.","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-18"},"PeriodicalIF":4.3,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnostic evolution of carbonic anhydrase 3 (CA3) in Amyotrophic Lateral Sclerosis (ALS): an emerging prognostic biomarker. 肌萎缩性侧索硬化症（ALS）中碳酸酐酶3 （CA3）的诊断进化：一种新兴的预后生物标志物。

IF 4.3 2区医学

Expert Review of Neurotherapeutics Pub Date : 2026-10-15 DOI: 10.1080/14737175.2026.2748281

Nitesh Sanghai, Geoffrey K Tranmer

{"title":"Diagnostic evolution of carbonic anhydrase 3 (CA3) in Amyotrophic Lateral Sclerosis (ALS): an emerging prognostic biomarker.","authors":"Nitesh Sanghai, Geoffrey K Tranmer","doi":"10.1080/14737175.2026.2748281","DOIUrl":"https://doi.org/10.1080/14737175.2026.2748281","url":null,"abstract":"Introduction: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease traditionally viewed as a motor neuron disorder in which muscle atrophy occurs secondary to neuronal loss. However, recent clinical proteomic advances have highlighted carbonic anhydrase 3 (CA3), a muscle-enriched enzyme, as a promising biomarker associated with ALS disease progression. Therefore, considering ALS a neurocentric disease is not untenable.Areas covered: In this review, the authors examined the emergence of CA3 as an ALS biomarker and evaluated evidence from recent large-scale clinical consortium studies supporting its diagnostic and prognostic utility. They also compare CA3 with established biomarkers, neurofilament light chain (NEFL), a surrogate endpoint approved by the FDA.Expert opinion: Discoveries of CA3 biomarker in ALS highlight that peripheral skeletal muscle is not merely a passive bystander, but an integral participant in ALS disease progression. Unlike NEFL, which primarily reflects neuroaxonal injury, CA3 may capture early neuromuscular dysfunction preceding motor neuron degeneration. CA3's emergence as an ALS biomarker supports a more integrated neuromuscular model of ALS and provides a compelling rationale for incorporating CA3 into multimodal diagnostic, prognostic, and pharmacodynamic biomarker panels to accelerate ALS drug discovery, therapeutic evaluation, and precision clinical trial development, highlighting their complementary roles in early diagnosis, patient stratification, and therapeutic clinical trial design.","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-7"},"PeriodicalIF":4.3,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current and emerging neuromodulation techniques for motor recovery after ischemic stroke: a 2026 update. 缺血性中风后运动恢复的当前和新兴神经调节技术：2026年更新。

IF 4.3 2区医学

Expert Review of Neurotherapeutics Pub Date : 2026-10-13 DOI: 10.1080/14737175.2026.2744756

Salman Ikramuddin, Ziping Huang, Lei Zhu, Xiquan Hu, Haiqing Zheng, Wuwei Feng

{"title":"Current and emerging neuromodulation techniques for motor recovery after ischemic stroke: a 2026 update.","authors":"Salman Ikramuddin, Ziping Huang, Lei Zhu, Xiquan Hu, Haiqing Zheng, Wuwei Feng","doi":"10.1080/14737175.2026.2744756","DOIUrl":"https://doi.org/10.1080/14737175.2026.2744756","url":null,"abstract":"Introduction: Neuromodulation technologies have emerged as promising tools to enhance motor recovery following ischemic stroke. Acute reperfusion therapy remains highly time-dependent, underscoring the need for interventions that augment post-stroke neuroplasticity. Brain stimulation techniques aim to modulate cortical excitability and promote adaptive reorganization of motor networks during the critical recovery period after stroke.Areas covered: The authors review recent advances in neuromodulation strategies for post-stroke motor recovery, as well as the key principles underlying neuromodulation. Major noninvasive modalities, including transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and low-intensity focused ultrasound stimulation (LIFUS), are reviewed alongside emerging applications of invasive techniques such as deep brain stimulation (DBS) and vagus nerve stimulation (VNS). Recent randomized clinical trials and translational studies are also highlighted. This article is based on literature obtained through PubMed and ClinicalTrials.gov searches for content published between 1 January 2020 and 30 March 202630 March 2026 and was supplemented by earlier landmark studies relevant to stroke recovery and neuromodulation.Expert opinion: Although neuromodulation technologies demonstrate encouraging safety profiles, clinical trial results feature notable neutral results. Future studies bear the burden of refining stimulation paradigms, patient selection, and rehabilitation dosing, possibly leveraging personalized, biomarker-driven patient selection.","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-15"},"PeriodicalIF":4.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

When sex matters early: clues from pediatric onset multiple sclerosis. 性行为何时起作用：来自小儿多发性硬化症发病的线索。

IF 4.3 2区医学

Expert Review of Neurotherapeutics Pub Date : 2026-10-12 DOI: 10.1080/14737175.2026.2744752

Lorena Lorefice, Robert Zivadinov

{"title":"When sex matters early: clues from pediatric onset multiple sclerosis.","authors":"Lorena Lorefice, Robert Zivadinov","doi":"10.1080/14737175.2026.2744752","DOIUrl":"https://doi.org/10.1080/14737175.2026.2744752","url":null,"abstract":"Introduction: Pediatric-onset multiple sclerosis (POMS) provides a unique developmental model to investigate when sex differences first emerge in multiple sclerosis (MS). As disease onset occurs during immune, endocrine, and neural maturation, POMS offers an opportunity to understand how puberty may shape disease susceptibility and subsequent trajectories.Areas covered: This review synthesizes evidence from epidemiological, clinical, neuroimaging, biomarker, and therapeutic studies across prepubertal, peripubertal, and post-pubertal stages. Articles published between 2000 and 2025 were identified through a PubMed/MEDLINE search using terms related to POMS, sex differences, and puberty. Available data indicate that the transition from childhood to adolescence coincides with the emergence of female predominance and sex-dependent patterns of tissue injury. MRI, retinal imaging, and fluid biomarkers suggest that differences in neuroaxonal vulnerability may be detectable early in the disease course. However, most studies remain sex-agnostic.Expert opinion: Sexual dimorphism in MS may emerge earlier than previously recognized, with puberty representing a critical window in which sex-related biological changes begin to shape disease susceptibility and expression. Incorporating sex and pubertal stage into longitudinal POMS research may help elucidate the mechanisms driving these differences, refine early risk stratification, and ultimately support more individualized therapeutic strategies across the MS lifespan.","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-12"},"PeriodicalIF":4.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

DT120 (MM120): a single-dose orally disintegrating formulation of lysergide tartrate for generalized anxiety disorder. DT120 (MM120)：用于广泛性焦虑障碍的单剂量口服崩解制剂酒石酸莱丝吉特。

IF 4.3 2区医学

Expert Review of Neurotherapeutics Pub Date : 2026-10-08 DOI: 10.1080/14737175.2026.2744754

Wiesław J Cubała

{"title":"DT120 (MM120): a single-dose orally disintegrating formulation of lysergide tartrate for generalized anxiety disorder.","authors":"Wiesław J Cubała","doi":"10.1080/14737175.2026.2744754","DOIUrl":"https://doi.org/10.1080/14737175.2026.2744754","url":null,"abstract":"Introduction: Generalized anxiety disorder (GAD) is a chronic, disabling condition for which currently available pharmacotherapies have delayed onset, incomplete remission rates, treatment-emergent adverse effects and substantial real-world discontinuation. DT120, formerly MM120, is an investigational orally disintegrating tablet formulation of lysergide tartrate being developed as a single-dose treatment for GAD.Areas covered: This drug profile evaluates the GAD treatment landscape, DT120 nomenclature and formulation, lysergide pharmacology, the phase 2b MM120 efficacy and safety data, the ongoing phase 3 Voyage and Panorama programs, regulatory considerations and requirements for clinical implementation. PubMed, Embase, ClinicalTrials.gov, regulatory guidance and public sponsor disclosures were reviewed through to the 14th of September 2026.Expert opinion: The phase 2b dose-finding study provides a credible signal of rapid and durable anxiolytic activity after one 100 microgram administration without protocol-mandated psychotherapy. However, DT120 should not be described as microdosing or modified release: 100 micrograms is a perceptible psychedelic dose, whereas controlled microdosing studies have generally used 5-20 micrograms, and the pivotal product is described publicly as a fast-dissolving orally disintegrating tablet. Adoption will depend on full peer-reviewed reporting of the positive Voyage and Panorama phase 3 topline results, formulation bridging, durability and retreatment data, management of functional unblinding, and a scalable monitored-care model.","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-11"},"PeriodicalIF":4.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Precision cognitive neurorehabilitation: dose, adaptivity, digital therapeutics and implementation. 精确认知神经康复：剂量，适应性，数字治疗和实施。

IF 4.3 2区医学

Expert Review of Neurotherapeutics Pub Date : 2026-10-04 DOI: 10.1080/14737175.2026.2723909

Florian W Sander, Étienne Sallard, Mauro Silva, Laurence Schneider, Karin Diserens, Christophe Graf, Andrea Serino, Arseny A Sokolov

{"title":"Precision cognitive neurorehabilitation: dose, adaptivity, digital therapeutics and implementation.","authors":"Florian W Sander, Étienne Sallard, Mauro Silva, Laurence Schneider, Karin Diserens, Christophe Graf, Andrea Serino, Arseny A Sokolov","doi":"10.1080/14737175.2026.2723909","DOIUrl":"https://doi.org/10.1080/14737175.2026.2723909","url":null,"abstract":"Introduction: Cognitive deficits are determinants of long-term disability and socio-professional reintegration across neurological disorders, including stroke, traumatic brain injury, multiple sclerosis, and neurodegenerative diseases. Despite evidence supporting cognitive neurorehabilitation, its implementation remains heterogeneous, and therapeutic parameters are insufficiently defined.Areas covered: The authors reviewed the published literature from PubMed and Google Scholar from 1 January 2015 to 30 June 2026, supplemented by seminal publications. Clinical trials, systematic reviews, meta-analyses, and observational and proof-of-concept studies were prioritized. This brief narrative review examines restorative and compensatory cognitive neurorehabilitation for deficits of attention, executive functions, language and disorders of consciousness in people after stroke and traumatic brain injury (TBI), older adults, and those with neurological and neurodegenerative conditions, including multiple sclerosis, Alzheimer's and Parkinson's disease. Emphasis is placed on dose, frequency, adaptivity, personalization, and digital and technology-assisted interventions. Methodological challenges include heterogeneity of protocols, limited use of active control conditions, insufficient long-term follow-up, and the gap between cognitive test improvements and meaningful effects on participation.Expert opinion: Advancing cognitive neurorehabilitation requires precision-driven approaches integrating digital therapeutics with clinical frameworks. Large-scale pragmatic trials, meaningful endpoints, and implementation strategies across the continuum of care will be essential to transform cognitive neurorehabilitation into a component of neurological practice.","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-18"},"PeriodicalIF":4.3,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Low amplitude pulse seizure therapy (LAP-ST): a form of seizure therapy with potential for reduced cognitive and memory side effects - a narrative review. 低幅度脉冲癫痫治疗（LAP-ST）：一种癫痫治疗形式，具有减少认知和记忆副作用的潜力-叙述性回顾。

IF 4.3 2区医学

Expert Review of Neurotherapeutics Pub Date : 2026-10-02 DOI: 10.1080/14737175.2026.2741119

Emad Sidhom, Georgia Eagleton, Passent Helal, Benjamin R Underwood, Nagy A Youssef

{"title":"Low amplitude pulse seizure therapy (LAP-ST): a form of seizure therapy with potential for reduced cognitive and memory side effects - a narrative review.","authors":"Emad Sidhom, Georgia Eagleton, Passent Helal, Benjamin R Underwood, Nagy A Youssef","doi":"10.1080/14737175.2026.2741119","DOIUrl":"https://doi.org/10.1080/14737175.2026.2741119","url":null,"abstract":"Introduction: Low Amplitude Seizure Therapy (LAP-ST) is a modification of electroconvulsive therapy (ECT) in which current amplitude is reduced below the 800-900 mA used by contemporary current-constant devices. Preliminary studies have investigated whether this approach can retain therapeutic effects while reducing cognitive adverse effects.Areas covered: The authors review the historical origins of low-amplitude convulsive stimulation, the electric-field rationale for amplitude reduction, and clinical evidence for LAP-ST. We searched PubMed, MEDLINE, EMBASE and PsycINFO (inception to May 2026) and hand-searched historical sources and reference lists. The authors give review to an identified pilot case series, two open-label studies (feasibility; proof-of-concept), two double-blind randomized trials (one a pilot reported across three publications) and a prospective amplitude-titration trial, alongside finite-element modeling studies, which are included herein.Expert opinion: Low pulse amplitude was used to elicit therapeutic seizures decades before fixed-current devices became standard. Pilot LAP-ST trials found no clear differences in antidepressant or anti-suicidal outcomes versus standard right-unilateral ultra-brief ECT and report shorter post-ictal reorientation times. Reorientation time is the strongest predictor of retrograde autobiographical memory change after ECT, though not direct evidence of preserved memory. Larger, adequately powered randomized trials are needed, ideally combining low amplitude with ultra-brief pulses, focal electrode placement and individualized E-field-informed dosing.","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-8"},"PeriodicalIF":4.3,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Contemporary approaches to Sydenham's chorea - where evidence meets reality. 西德纳姆舞蹈症的当代研究方法——证据与现实相遇。

IF 4.3 2区医学

Expert Review of Neurotherapeutics Pub Date : 2026-10-01 DOI: 10.1080/14737175.2026.2742388

Andrea Santangelo, Maria Cristina Maggio, Alessandro Orsini, Giuseppe Santangelo, Pasquale Striano, Giovanni Corsello

{"title":"Contemporary approaches to Sydenham's chorea - where evidence meets reality.","authors":"Andrea Santangelo, Maria Cristina Maggio, Alessandro Orsini, Giuseppe Santangelo, Pasquale Striano, Giovanni Corsello","doi":"10.1080/14737175.2026.2742388","DOIUrl":"https://doi.org/10.1080/14737175.2026.2742388","url":null,"abstract":"Introduction: Sydenham's chorea (SC) is the most common acquired chorea of childhood and a major neurological manifestation of acute rheumatic fever. Although often considered self-limiting, it can cause substantial motor, psychiatric, cognitive, educational, and social morbidity, with relapses in a relevant proportion of patients.Areas covered: In this critical perspective, the authors critically examined current approaches to SC management, focusing on three complementary pillars: eradication of Group A β-hemolytic streptococcal infection and long-term secondary antibiotic prophylaxis; symptomatic control; and immunomodulation. Antibiotic prophylaxis is essential to prevent recurrent rheumatic fever, rheumatic heart disease progression, and neurological relapse, but does not treat the established autoimmune episode. Anti-seizure medicaments are generally preferred for symptomatic treatment because of their favorable efficacy-tolerability balance, while dopamine receptor antagonists should be reserved for severe hyperkinesia because of drug-induced movement disorders. Recent evidence supports earlier use of corticosteroids in moderate-to-severe or disabling SC, whereas intravenous immunoglobulin and plasma exchange remain escalation options for selected severe or steroid-resistant cases.Expert opinion: Treatment response should be assessed by functional recovery, not motor improvement alone. Future progress will depend on prospective registries, standardized outcome measures, pragmatic multicenter trials, and biomarker studies to enable more individualized therapeutic decisions. Systematic neuropsychiatric assessment and multidisciplinary support are therefore integral to comprehensive care.","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1-10"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluating seltorexant as a treatment option for major depressive disorder. 评价seltorexant作为重度抑郁症的治疗选择。

IF 4.3 2区医学

Expert Review of Neurotherapeutics Pub Date : 2026-10-01 Epub Date: 2026-08-29 DOI: 10.1080/14737175.2026.2717199

Marco Di Nicola, Maria Pepe, Ilaria Marcelli, Isabella Panaccione, Gabriele Sani

{"title":"Evaluating seltorexant as a treatment option for major depressive disorder.","authors":"Marco Di Nicola, Maria Pepe, Ilaria Marcelli, Isabella Panaccione, Gabriele Sani","doi":"10.1080/14737175.2026.2717199","DOIUrl":"10.1080/14737175.2026.2717199","url":null,"abstract":"Introduction: Major depressive disorder is a leading cause of disability, with a significant rate of patients responding inadequately to antidepressants, and residual symptoms, including insomnia, worsening overall outcomes. Current adjunctive options display partial efficacy and tolerability, motivating the search for different strategies. Beyond regulating the sleep-wake cycle, orexin systems are implicated in reward and cognition, and have emerged as new targets for depressive disorders.Areas covered: This Drug Profile summarizes the published peer-reviewed evidence on seltorexant (JNJ-42847922; MIN-202), a selective orexin-2 receptor antagonist, for adjunctive treatment of MDD, covering its pharmacological, preclinical, and clinical profile, efficacy, safety and tolerability, head-to-head comparisons with current adjunctive treatments, regulatory status, and competitive landscape. Relevant literature was identified through structured searches of PubMed/MEDLINE and ClinicalTrials.gov (from database inception to April 2026), complemented by Google Scholar employed solely to identify conference proceedings, using combinations of terms related to seltorexant and depression.Expert opinion: Seltorexant 20 mg has shown a promising antidepressant effect, particularly in patients with clinically significant insomnia, and a favorable tolerability profile. The mixed phase-3 results, the modest effect sizes, and gaps on core symptoms of depression, including anhedonia and suicidality, and on long-term safety warrant a measured positive view, pending confirmatory data.","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"909-921"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acetazolamide use in idiopathic intracranial hypertension: a real-world cohort study of side effects. 乙酰唑胺用于特发性颅内高压：一项真实世界的副作用队列研究。

IF 4.3 2区医学

Expert Review of Neurotherapeutics Pub Date : 2026-10-01 Epub Date: 2026-09-24 DOI: 10.1080/14737175.2026.2733195

Ronya Sari, Martin Jørgen Lønborg Friis, Henrik Winther Schytz, Rigmor Højlund Jensen, Dagmar Beier, Nadja Skadkær Hansen

{"title":"Acetazolamide use in idiopathic intracranial hypertension: a real-world cohort study of side effects.","authors":"Ronya Sari, Martin Jørgen Lønborg Friis, Henrik Winther Schytz, Rigmor Højlund Jensen, Dagmar Beier, Nadja Skadkær Hansen","doi":"10.1080/14737175.2026.2733195","DOIUrl":"10.1080/14737175.2026.2733195","url":null,"abstract":"Background: Acetazolamide is an off-label-first-line treatment for idiopathic intracranial hypertension (IIH) with high discontinuation rates due to side effects. This research assesses prescribing patterns and tolerability by dosage, papilledema severity, and potassium supplementation.Methods: Within a prospective cohort of newly diagnosed IIH patients from two tertiary headache centers, acetazolamide-related side effects were retrospectively registered until tapering due to intolerance or papilledema remission. Side effects were categorized by dose (>0-1000 mg, >1000-2000 mg, >2000-3000 mg, >3000-4000 mg). Potassium and bicarbonate supplementation were evaluated.Results: Among 139 acetazolamide-treated patients (97% female, median age 28 years (IQR 25-36), median BMI 35 (IQR 30-39)) side effects were noted in 99%, but led to dosage reduction or discontinuation in 22%. Acroparesthesia (85%) was most frequent, hereafter dysgeusia (51%), fatigue (46%), nausea/vomiting (34%), and tinnitus, dizziness, and cognitive symptoms (25% each). Serious adverse events included liver impairment (n = 1), kidney stones (n = 3), hearing loss (n = 1) and pulmonary embolism (n = 1). Potassium supplementation yielded fewer dosage-limiting side effects (p = 0.02), and bicarbonate alleviated metabolic acidosis symptoms in 8/12 patients.Conclusion: Side effects are near-universal but tolerable. Further research is needed whether potassium and bicarbonate supplementation improves acetazolamide tolerability and adherence.","PeriodicalId":12190,"journal":{"name":"Expert Review of Neurotherapeutics","volume":" ","pages":"1005-1015"},"PeriodicalIF":4.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0