Flupirtine — Another Potassium Channel Opener

Discussion in 'Treatments' started by Mikel, Jul 29, 2014.

    1. JeffDamsko

      JeffDamsko Member

      Tinnitus Since:
      2010
      Thanks for this update. This sounds very promising, although I'm not letting myself get to excited.
       
    2. lapidus

      lapidus Member Benefactor

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      Noise induced
      http://www.feinberg.northwestern.edu/news/2015/02/garcia-auditory-pathway.html
      This discovery was made recently and there is a thread in research section for this too. I find these quotes interesting:

      "The discovery offers an entirely new way of looking at the painful and intractable hearing conditions hyperacusis and tinnitus,"

      "We do not know how to treat these debilitating conditions, and understanding what neuronal pathway might be involved is essential. If we find they are actually pain syndromes rather than hearing syndromes, perhaps they could be treated effectively with analgesic pain medication that acts on the brain.”

      Flupirtine is analgesic that acts on the brain.
      How is it going now @attheedgeofscience ?
       
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    3. Zimichael

      Zimichael Member Benefactor

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    4. nills
      Barefooter

      nills Member Benefactor

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      Thanks for this great summary, I just have a technical question for you; Would previous use of one medicine influence the effect of the other. Would RTG have possible negative effects on the efficacy of AUT?

      thanks
       
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    5. DebInAustralia
      Fine

      DebInAustralia Member Benefactor Advocate

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      I ditto Nills above question. this also concerns me and is one of the reasons why I keep thinking ill hold off from trialling retigabine.
       
    6. undecided
      Breezy

      undecided Member

      Location:
      Greece
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      Cause of Tinnitus:
      Unknown.
      Is there any evidence for the efficacy of AUT?
       
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    7. Zimichael

      Zimichael Member Benefactor

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      Well I can't answer for AUT00063, but if you believe the Pharma stuff then Retigabine plasma half-life is 8 - 10 hours, and plasma clearance = 98% after 10 days. By the time Autifony comes along for us it will be a LOT longer than that!

      Plasma Clearance: Ezogabine and its N-acetyl metabolite have similar elimination half-lives (t½) of 7 to 11 hours. The clearance of ezogabine following intravenous dosing was approximately 0.4 to 0.6 L/hr/kg. Ezogabine is actively secreted into the urine.

      Elimination: Results of a mass balance study suggest that renal excretion is the major route of elimination for ezogabine and NAMR. About 85% of the dose was recovered in the urine, with the unchanged parent drug and NAMR accounting for 36% and 18% of the administered dose, respectively, and the total N-glucuronides of ezogabine and NAMR accounting for 24% of the administered dose. Approximately 14% of the radioactivity was recovered in the feces, with unchanged ezogabine accounting for 3% of the total dose. Average total recovery in both urine and feces within 240 hours after dosing is approximately 98%.


      Most of the sources I saw fell into these ranges above...But as we know, we are all "unique" in relation to detox pathways and whatever 'deficiencies'. If you have renal issues and such, I'm sure clearance may be slower.

      Best, Zimichael
       
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    8. linearb
      Psychedelic

      linearb Member Benefactor Hall of Fame

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      the trials are still underway...
       
    9. Juan Carlos
      Whistles

      Juan Carlos Member Benefactor

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      Interesting, so you mean that AUT half-live time is way longer than RTG? how long? how do u know this?
       
    10. Zimichael

      Zimichael Member Benefactor

      Location:
      N. California
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      (1956) > 1980 > 2006 > 2012 > (2015)
      Cause of Tinnitus:
      Ac. Trauma & Ac.Trauma + Meds.
      Sorry JC...sloppy English there.

      What I meant was, that by the time AUT00063 comes along and is available to us it will be years. Thus much, much longer than "any half life" or "plasma clearing rate" of the drugs we are generally talking about, like Flupirtine, Retigabine, Keppra, etc.

      I have no idea what the plasma clearance time is for AUT00063.

      Hope that makes it clearer. Best, Zimichael
       
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    11. linearb
      Psychedelic

      linearb Member Benefactor Hall of Fame

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      I have a friend who was too impatient to wait for suvorexant to come to market, and had his own batch custom synthesized by an unscrupulous overseas chemical lab.

      On that note... does anyone know what the actual molecule is for AUT00063? That may be a closely held secret at the moment, but it will doubtless need to become public well before sales...
       
    12. Zimichael

      Zimichael Member Benefactor

      Location:
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      (1956) > 1980 > 2006 > 2012 > (2015)
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      Here you go...Good luck understanding it all!!! (And I guess this should be, or already is, in the Autifony thread):

      http://www.faqs.org/patents/app/20130267510
       
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    13. linearb
      Psychedelic

      linearb Member Benefactor Hall of Fame

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      well, that's everything one would need to know to cook this up, but wow is that a complex molecule. 200 step synthesis to get to (5R)-5-ethyl-5-methyl-3-(6-{[4-methyl-3-(methyloxy)phenyl]oxy}-3-pyridinyl- )-2,4-imidazolidinedione ..... this makes synthesizing LSD look simple!
       
    14. Zechariah

      Zechariah Member Benefactor

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      Hi, ATEOS, anything worth updating? I assume you are closing up the end of your flupirtine course because of liver toxicity risk.

      I'm asking because I'm really interested on trying flupirtine which seems to be, as you said earlier, a better alternative for Trobalt/Retigabine in means of side effects.
       
    15. Christian78
      Alone

      Christian78 Member

      Location:
      Gothenburg
      Tinnitus Since:
      (Sep 2013)
      Cause of Tinnitus:
      progressive tinnitus, time of expiring in next 3-6 months
      Well is it ototoxic? how to behave with it, maybe some live regenerators....

      Who will test it?
       
    16. 1MW
      No Mood

      1MW Member

      Tinnitus Since:
      2008 but cured and relapsed from benzos
      Cause of Tinnitus:
      ssnhl/benzos/unknown
      I can not find retigabine but i can find a lot of flupirtine is a good alternative ?
       
    17. cqman
      Pooptoast

      cqman Member

      Tinnitus Since:
      02/2013
      Still on 400mg per day?

      just doubled the dosage, amazing result. Dosage really matters.
       
    18. Juan Carlos
      Whistles

      Juan Carlos Member Benefactor

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      are you taking it? what are the results?
       
    19. cqman
      Pooptoast

      cqman Member

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      No, I meant ATEOS just doubled the dosage.
       
    20. Zechariah

      Zechariah Member Benefactor

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      Does anyone know if @attheedgeofscience is waiting a bit to give a "proper" update on this thread? He seems to be logging to forum but not responding to this thread.
       
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    21. 1MW
      No Mood

      1MW Member

      Tinnitus Since:
      2008 but cured and relapsed from benzos
      Cause of Tinnitus:
      ssnhl/benzos/unknown
      I got 400mg .
      To me has some minor effect nothing special is like a low dose benzo.
      Calms the edge of T & H a little.
      Also gives me a general calm feeling.
      Have anyone combined retigabine+flupirtine (in small doses)?
       
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    22. attheedgeofscience
      No Mood

      attheedgeofscience Member Mighty Benefactor Hall of Fame

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      See information page
      Potential suppression of tinnitus with potassium channel openers like Trobalt and Flupirtine is likely to depend on both the dosage and the length of treatment (most people on this forum have some understanding of this by now, needless to say).

      The pioneering research paper on pharmacology and tinnitus (using currently available potassium channel modulators on the market) titled "Pharmacodynamics of potassium channel openers in cultured neuronal networks" by Prof. Moore and colleagues examines thoroughly the pharmacology of four different K+ channel openers. Here is a small excerpt from their paper:

      upload_2015-3-27_21-10-16.png

      The entire paper is now available for free @:

      www.researchgate.net/publication/261220232_Pharmacodynamics_of_posstassium_channel_openers_in_cultured_neuronal_networks

      As can be seen from the graphs, above, the normalization of the relative spike rate depends on both the dosage and the drug itself (i.e. Trobalt [RTG] would be "superior" to Flupirtine [FPT], in this case). This is what is defined as the therapeutic concentration (TC). How that translates into dosages in the "human laboratory" is another matter, of course. But the graphs illustrate clearly how dosage plays a potentially significant factor in the suppression of tinnitus.

      Maximum daily allowed dosage with Flupirtine is 600 mg. Apparently the maximum recommended treatment duration is restricted to two weeks. The (potential) treatment of tinnitus using Flupirtine is off-label. Ultra short-term (e.g. for one day) dosage increase beyond 600 mg / day is "probably safe", but not really recommended (based on discussions I have had with a professor of neurosurgery).

      I have reliable information that the professors behind the research paper, above, have both the capability and the competence to quantify the neurotoxicity of the drugs investigated in the paper as well as undertake research into more advanced compounds with higher selectivity of the specific potassium channels (and less toxicity). Being researchers at public universities, I have no doubt that they would appreciate further funding. I also have no doubt that they would be able to "make a difference" in tinnitus research.

      attheedgeofscience
      27/MAR/2015.
       
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    23. Martin69
      Artistic

      Martin69 Member Benefactor

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      @attheedgeofscience
      ATEOS. Thanks for sharing. As always, highly valuable for us.
      So if I understand correctly, this paper confirms the efficiency in calming neuronal acticity and therefore suppressing Tinnitus. But we have no long-term studies, right? Do you know if anything is planned in this direction (for example by a pharma company)?
      Or is it up to the board members here to continue doing their own studies with Trobalt?
      Thanks again.
       
    24. NiNyu

      NiNyu Member

      Tinnitus Since:
      29/12/2014
      Cause of Tinnitus:
      barotrauma? stress?
      That's profoundly interesting! I've been asking myself the very same question lately. Did anybody for example try opioids like morphine?
       
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    25. attheedgeofscience
      No Mood

      attheedgeofscience Member Mighty Benefactor Hall of Fame

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      The study was done in vitro (i.e. not done on animals or humans, but in a lab). In this setting, the study simulated tinnitus like activity and observed the effects of four different drugs (along with various concentrations of the drugs). Under these simulated conditions, the study showed that the four drugs tested would have the potential to suppress tinnitus.
      Right now, we have no proper studies at all (i.e. no short or long term studies). The only "kind of" study we have is the study that the members of TinnitusTalk are behind (i.e. the informal Trobalt Trial) - which means that TinnitusTalk is actually ahead of the game, so to speak. The problem is that the data Team Trobalt collected does not live up to scientific standards. With a bit of luck, the publication of the research paper that TRI is behind will pave the way for a proper study (by creating awareness).
      See above. Also see:

      www.tinnitustalk.com/threads/retigabine-trobalt-potiga-%E2%80%94-general-discussion.5074/page-141#post-101671

      And...
      Source: www.tinnitustalk.com/threads/british-tinnitus-association-q-a.7746/#post-89720

      Personally, I believe the best route to follow is to get involved in advocacy and contact relevant government organizations and/or pharmas. Share the knowledge - as appropriate - and persevere. Spending hours on a forum brings little value.

      What top-class researchers such as professor Moore can do, is to undertake research into the pharmacology of the current compounds and/or look for safer and/or more effective alternatives. This is a slightly different topic.
      Trobalt is currently available (even off-label). Anyone who wishes to try it can do so (provided they can find a doctor willing to prescribe it...). What members on TinnitusTalk can do, is help understand just how effective Trobalt is (by reporting their progress reliably and in a timely fashion). With enough reliable results, that could pave the way for a proper study of Trobalt under controlled conditions. Such a study may then indicate that Trobalt is or - is not - effective against tinnitus in general or it may show just efficacy with a specific sub-type of tinnitus.
       
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    26. 1MW
      No Mood

      1MW Member

      Tinnitus Since:
      2008 but cured and relapsed from benzos
      Cause of Tinnitus:
      ssnhl/benzos/unknown
      The good with flupirtine is that a pill 400mg last many hours.
      With RTG the result lasts max 1.5-2 hours.
      For liver toxicity maybe we can use some antidote for use more than 15 days...
       
    27. 1MW
      No Mood

      1MW Member

      Tinnitus Since:
      2008 but cured and relapsed from benzos
      Cause of Tinnitus:
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      Update i got 2nd pill today and seems better than RTG.
      Is like RTG plus benzo.
      Nice effect on T & H.
      I remember when my T stopped on it's own without any med for a couple of hours i had the same feeling/calmness that gives the flupirtine
       
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    28. attheedgeofscience
      No Mood

      attheedgeofscience Member Mighty Benefactor Hall of Fame

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      Yes it does, doesn't it? And so does the health of my liver...
       
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    29. 1MW
      No Mood

      1MW Member

      Tinnitus Since:
      2008 but cured and relapsed from benzos
      Cause of Tinnitus:
      ssnhl/benzos/unknown
      I will do exams for liver enzymes after 7 days of use.
      We must find antidote for liver toxicity because this drug is very good.
       
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    30. undecided
      Breezy

      undecided Member

      Location:
      Greece
      Tinnitus Since:
      04/2014
      Cause of Tinnitus:
      Unknown.
      @1MW out of curiosity, how did you get your hands on Flupirtine?
      It's not available on greek pharmacies? Did you order from abroad?
       

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