TY - JOUR T1 - The Mechanism of Carbamazepine Aggravation of Absence Seizures JF - Journal of Pharmacology and Experimental Therapeutics JO - J Pharmacol Exp Ther SP - 790 LP - 798 DO - 10.1124/jpet.106.104968 VL - 319 IS - 2 AU - Lige Liu AU - Thomas Zheng AU - Margaret J. Morris AU - Charlott Wallengren AU - Alison L. Clarke AU - Christopher A. Reid AU - Steven Petrou AU - Terence J. O'Brien Y1 - 2006/11/01 UR - http://jpet.aspetjournals.org/content/319/2/790.abstract N2 - Carbamazepine (CBZ) aggravates many generalized seizures types, particularly absence seizures, but the mechanisms underlying this are poorly understood. GABA signaling within the reticular nucleus (Rt) and the ventrobasal complex (VB) of the thalamus is critical to the neurophysiology of absence seizures. The hypothesis that CBZ aggravates absence seizures by acting at the VB thalamus via a GABAA receptor-mediated mechanism was investigated in a genetic rat model, generalized absence epilepsy rats from Strasbourg (GAERS). Seizure activity was quantified by a 90-min electroencephalogram recording postdrug injection. Intracerebroventricular injections of CBZ (15 μg in 4 μl) resulted in seizure aggravation versus vehicle treatment, with a mean increase in seizure time of 40%. This indicates that CBZ acts directly, rather than via a metabolite, on the brain to aggravate seizures. Seizure aggravation also occurred following bilateral microinjection of CBZ (0.75 μg in 0.2 μl) into the VB (53%) but not following injection into the Rt (–9%). However, seizure aggravation was blocked when the GABAA receptor antagonist, bicuculline (BIC, 0.04 μg in 0.2 μl), was coinjected with CBZ into the VB. Injection of BIC alone (versus vehicle) into the VB also blocked seizure aggravation following systemic administration of CBZ (15 mg/kg i.p.). In vitro studies in Xenopus oocytes expressing recombinant GABAA receptors demonstrated that CBZ produced a dose-dependent potentiation of the GABA current at a physiological relevant concentration range (1–100 μM). These data demonstrate that CBZ acts at the VB thalamus to aggravate absence seizures in GAERS and that activation of GABAA receptors is critical to this effect. The American Society for Pharmacology and Experimental Therapeutics ER -