How Do Other Neurologic Drugs Work?

Neurologic drugs are medications used to treat different types of neurological disorders. Medications that do not fall into any specific class of neurologic drugs are categorized as other neurologic drugs. Other neurologic drugs include the following medications which work in different ways:

• Edaravone: Edaravone is a medication used to treat amyotrophic lateral sclerosis (ALS), a neurodegenerative disorder that causes progressive muscle wasting. Edaravone is believed to work by reducing oxidative stress, a part of the process that destroys nerve cells (neurons) in patients with ALS.
  • Oxidative stress is an imbalance between free radicals (reactive oxygen species/ROS) and antioxidants that neutralize them. Free radicals play an essential role in biological processes, but excessive ROS cause cellular and DNA damage. Edaravone acts as an antioxidant, and delays disease progression by scavenging the free radicals.
• Elamipretide: Elamipretide is a medication being developed to treat mitochondrial diseases, awaiting FDA approval. Mitochondria are small organelles within cells that generate the energy that all cells need to survive. Neuromuscular disorders are typical features of mitochondrial diseases because neurons and muscle cells have high energy needs.
  • Elamipretide binds to and enhances the activity of cardiolipin, an essential lipid (fat) component of the inner mitochondrial membrane. Elamipretide improves energy generation, reduces the production of free radicals and oxidative stress, increasing the availability of adenosine triphosphate (ATP), the energy molecules of cells.
• Nimodipine: Nimodipine is used in patients who have had a brain aneurysm rupture, to reduce the incidence and severity of neurological deficits caused by reduced blood flow (ischemia) into the brain due to the hemorrhage. Nimodipine prevents cerebral vasospasm and dilates the cerebral arteries, improving blood flow.
  • Nimodipine is a calcium channel blocker that inhibits the inflow of calcium ions into the smooth muscle cells around the blood vessels, making them relax. Nimodipine crosses the blood-brain barrier easily and has primary effects on the cerebral arteries and minimal effects on the heart.
• Onasemnogene abeparvovec: Onasemnogene abeparvovec is used to treat spinal muscular atrophy (SMA) type-1, a neuromuscular disease caused by the absence of or defects in the survival motor neuron 1 (SMN1) gene. The SMN1 gene encodes SMN protein, essential for maintaining the health and normal functioning of motor neurons.
  • Onasemnogene abeparvovec is a one-time gene replacement therapy administered with intravenous infusion. A non-infectious virus delivers a fully functional SMN1 gene into the motor neurons, which helps increase the production of SMN protein.

Other neurologic drugs may be administered as oral capsules or solutions, and intravenous (IV) infusions into the vein. Other neurologic drugs may be used in the treatment of conditions that include:

• Edaravone:
  • Amyotrophic lateral sclerosis (ALS), is a neurodegenerative disorder that causes progressive muscle weakness and atrophy
• Elamipretide: (pending FDA approval)
  • Barth syndrome, is a rare genetic disorder that primarily affects males and causes heart muscle weakness, low white blood cell count, undeveloped skeletal muscles, and muscle weakness
  • Primary mitochondrial myopathy, muscle disease caused by defects in the mitochondria, the structures within cells responsible for generating energy
  • Leber’s hereditary optic neuropathy, an inherited form of vision loss (orphan designation)
• Nimodipine:
  • Subarachnoid hemorrhage (bleeding in the space between arachnoid and pia mater, two layers of brain’s membranes), to improve neurological outcome by reducing incidence and severity of ischemic deficits caused by the hemorrhage
• Onasemnogene abeparvovec:
  • Spinal muscular atrophy type-1, is a hereditary genetic disease that affects the central and peripheral nervous systems, and voluntary muscle function

Side effects of other neurologic drugs vary with each drug. A few of the most common side effects may include:

• Edaravone:
  • Contusion
  • Gait disturbance
  • Headache
  • Skin and subcutaneous disorders including dermatitis and eczema
  • Respiratory failure, respiratory disorder, and hypoxia (low oxygen concentration in tissues)
  • Glycosuria (excessive sugar excretion in urine)
  • Tinea (fungal) infection
  • Hypersensitivity reactions and anaphylaxis (severe allergic reaction)
• Elamipretide:
  • Headache
  • Dizziness
  • Abdominal pain
  • Flatulence
  • Mild redness or itching at the injection site
• Nimodipine:
  • Reduction in systemic blood pressure
  • Diarrhea
  • Headache
  • Abdominal discomfort
  • Rash
  • Heart failure
  • Abnormal ECG and arrhythmia (irregular heartbeat)
• Onasemnogene abeparvovec:
  • Elevated aminotransferases (liver enzymes)
  • Vomiting
  • Thrombotic microangiopathy (microscopic clots in small arteries and capillaries)
  • Acute liver injury and failure
  • Pyrexia (fever)
  • Increase in levels of troponin (a protein found in heart muscles)

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these products do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of some of the other neurologic drugs include:

• edaravone
• elamipretide (pending FDA approval)
• Bendavia (pending FDA approval)
• nimodipine
• Nimotop
• Nymalize
• onasemnogene abeparvovec
• onasemnogene abeparvovec-xioi
• Radicava
• Zolgensma