Preface

**Pharmacology and Nutritional Intervention in the Treatment of Disease** covers topics of fundamental importance in biomedicine, basic principles of nutrition and pharmacology, health and disease research, as well as in basic biological research. While pharmacology is the science of drug action on biological systems, the nutritional aspect deals with general nutrition concepts with a focus on health promotion and therapeutic nutrition.

Food and nutrition play an intimate and inextricable role in all aspects of drug metabolism, comprising, among others, safety and effectiveness. The importance of food and nutrition in the bioavailability of drugs, and vice versa, has been an area of historical interest. In spite of many synthetic compounds, the most efficient drugs available are directly or indirectly re‐ lated to the plant kingdom. Many plant extracts have been shown to possess pharmacologi‐ cal actions. There is also accumulating evidence that the pharmacological actions, i.e. drug metabolism, distribution and effectiveness, depend on the nutritional status of a person. Natural products are a constant source of potentially active compounds for the treatment of various disorders. Natural products have, however, been largely replaced by synthetic drugs during the last century. However, the adverse side-effects and poor tolerability of many of these drugs have led to the investigation of the efficacy of dietary therapies for sev‐ eral disorders. For example, there is a body of evidence suggesting that metabolism-based therapy could often be considered as the initial treatment plan for patients with specific epi‐ lepsy syndromes.

Nutrient-based or natural therapies are gaining popularity for many reasons. People are be‐ coming aware of health-related information and are ready to consider disease prevention and treatments that are less intrusive than conventional allopathic medicine. Natural alter‐ native treatments can provide an opportunity to treat a condition with a first round protocol that is less harmful for natural cell chemistry than the treatment with hard-core synthetic pharmacology. The alternative treatments are based on natural pharmacological activity as well as on cofactor activity that acts as a passive building block. Furthermore, complementa‐ ry treatments have become popular because nutrigenomic science has helped us to learn more about the natural pharmacology of these remedies. This insight has allowed us to de‐ termine the activity of these natural biomedical treatments in relation to that of pharmaceut‐ ical drugs; providing reliable science-based information for safe alternative natural choices that can be applied as a first round treatment with reduced risk for side-effects. Nutrige‐ nomic science has also allowed veterinary and human health care professionals to apply confidently complementary medicine to treat patients with natural and conventional drugs in powerful synergy. Many herbal, vitamin, antioxidant and mineral compounds have phar‐ macological activity similar to that of drugs and are thus able to synergize the effects of a drug leading to lower doses of the drug required for successful treatment. The synergizing effect of some of these nutrient-based compounds is due to them acting through different pathways than the drug. However, many natural compounds (both nutritional and pharma‐ cological) can interfere with or even elevate drug activity, ranging from absorption and transport to liver metabolism and cellular activity. These interactions may change the ex‐ pected pharmacology of a drug and cause unexpected side-effects.

The unique contributions of individual vitamins and trace elements and their prevalence and distribution in foods provide an ever-expanding field of research which was born on the observations made by the two-time Nobel laureate Linus Carl Pauling (1901–1994). His scientific interest shifted to orthomolecular medicine and his findings on megavitamin ther‐ apy, dietary supplements and vitamin C are well known. Furthermore, Abram Hoffer (1917–2009) supported Pauling's conclusion that clinical application of therapeutic doses of specific B vitamins such as niacin and pyridoxine can be successfully used for the manage‐ ment of certain forms of schizophrenia.

Drugs and nutrients are not only involved in the same processes, their availability and func‐ tion are also intimately and inextricably entwined. The body's ability to process foreign sub‐ stances depends on metabolic systems that rely on essential nutrients (vitamins, minerals, fatty acids, and so forth) obtained through diet. This book contains a review of what is known about the general relationships between nutrition and pharmacology, as well as is‐ sues specific to disease therapies. The importance of food and nutrition for the bioavailabili‐ ty of drugs, and vice versa, has been an area of historical interest. However, much has been learned about the importance of nutritional status for drug metabolism, distribution and ef‐ fectiveness. The issues related to traditional therapies are highlighted as an area of clinical concern and one in need of further research. Additional attention is focused on the impact of individual micronutrients on drug pharmacokinetics and pharmacodynamics. We have to look more carefully at potential drug-nutrient interactions in the clinical setting and to ask the correct questions, particularly in settings in which poor nutrition might be anticipated. To support our ability to do that, we need to delineate more clearly the role of nutrients in pharmacology beyond just bioavailability.

> **Faik Atroshi, PhD** Pharmacology & Toxicology, University of Helsinki, Finland

**Chapter 1**

**Epilepsy Treatment and Nutritional Intervention**

Epilepsy is the most common chronic brain condition with epileptiform neuronal discharg‐ es, characterized by recurrent unproved seizures with at least two and at least 24 hrs apart. Epileptiform patterns in electroencephalogram (EEG) should confirm the diagnosis. It is the most expensive chronic neurological brain disorder in Europe (Andlin-Sobocki et al. 2005; Majkowski and Majkowska-Zwolińska, 2010). According to the World Health Organisa‐ tion and the World Bank, the costs of epilepsy constitutes 0.5% of all diseases (Leonardi

The incidence of epilepsy in the whole population is estimated as about 50-60 cases per 100.000 persons per year, and it is aged depending. In elderly, above 65 yrs old, it is increasing and about 80 yrs old is about 200 cases /100.000/year and in young preschool age children 100-150 / 100.000/year (Forsgeren, 2004). Worldwide prevalence of epilepsy is about 1% (in whole world about 50 millions of persons). However, according to Poter (1988), 45 to 100 million people worldwide were estimated to have epilepsy. Prevalence, like incidence, is age related; in age above 70 yrs it is highest (about 2%), and a little lower in infants. Extremes of life in humans are associated with increased incidence of epilepsy and increased susceptibility to oxygen stress in the developing immature brain (Lafemina et al., 2006) and in aged animals (Liang and Patel, 2004; Avramovic et al., 2012). It is an open question if there is a causal relation between

Occurrence of the first seizure, at any age, does not necessary mean epilepsy and a need for antiepileptic drug (AED) administration. It may be symptomatic and diagnostic procedure should be implemented to exclude or confirm an etiological cause. In the whole life of a person, from birth to death, at least one epileptic seizure may occur − including febrile convulsions − in about 8% of otherwise healthy population. In about one of them epilepsy will develop.

> © 2014 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Additional information is available at the end of the chapter

Jerzy Majkowski

**1. Introduction**

and Ustrun, 2002).

these two events.

**1.1. Epilepsy**

http://dx.doi.org/10.5772/57484
