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Retigabine (Trobalt, Potiga) — General Discussion

Hey, thanks for the graphical explanation :)

After reading some more wiki, I think I more or less understand now - IF the potassium channel is blocked, repolarization takes longer than usual (it still occurs via the sodium/potassium pumps), and therefore the membrane remains depolarized for longer, which means Ca2+ channels are activated for longer, and finally the Ca2+ sensitive neurotransmitter containing vesicles are more prone to releasing the neurotransmitter. In other words, neuron is more likely to fire and for a longer time.




Yes, read the paper quoted on that page http://www.sciencedirect.com/science/article/pii/S0378595511002620 and that pretty much states explicitly what I was asking about. For example,

"Our findings now show that the intrinsic electrical properties of FCs in the DCN are modified following exposure to loud sound. After AOE, a proportion of FCs exhibit a distinct bursting firing pattern, and thereby lose the ability to fire regularly or at high firing frequencies. Our results suggest that one mechanism contributing to this change of activity is the down regulation of HVA K+ currents in FCs." (Section 4, Discussion).

This more or less fits well with the explanation of how Kv channels slow down the repolarization, and therefore take longer to fire again (i.e. decreasing the firing frequency). The paper confirms this - "High voltage activated K+ currents enable cells to fire at high rates" and "By activating at depolarized potentials and rapidly deactivating, HVA K+ currents facilitate action potential repolarisation and lead to a short action potential duration. We found that FCs with a bursting pattern of firing exhibited significantly longer action potential decay times compared to unexposed FCs, which is consistent with a down regulation of HVA K+ currents."



Are you sure that is the right paper? I scanned through it, but couldn't find any mention of potassium channels.

As for how acoustic over exposure (AOE) induces fusiform cell (FC) bursts (related to blocked Kv channels, I presume) - the paper has a speculative section about that too (section 4.4). They say it could be due to "homeostatic adjustment" in the DCN (dorsal cochlear nucleus), but to fully understand that explanation I think I would have to do more research.



I hope so. The paper authors are very cautious in their conclusion (section 4.5) : "It is likely that tinnitus starts at the peripheral level and evolves throughout the central auditory pathway via a process that resembles memory consolidation. If this is the case, treating the first symptoms linked to acoustic over-exposure could be proven effective in slowing developing tinnitus at a later stage. The data provided here suggest that the Kv3 K+ channels in the central auditory system could be a target responsible for tinnitus at the early stages following acoustic over-exposure."

Hopefully it could also be a target at the late stages as well...

The article you mentionned is anterior to hamann/page findings as said by @rtwombly

Dude the answer to the glutamate thing is in the first quote, it's funny coz you're the second one I give it and who re-ask the same thing. :cat: No Rage :cat: (jk I don't mind to help!)

First link, page 11, just read the title it's what you want.
"KATP channels in glutamate mediated synaptic degeneration"

It's the echo of a very old article (1999 aka Tinnitus stone age):
http://www.ncbi.nlm.nih.gov/pubmed/10842598

Third link is also talking about the phenomenom in a more subtle manner. The thing is also you should not look for glutamate as a keyword but more VGLUT, but this is a very (very) complex mechanism you want to dig into. I don't want to introduce the notion of solute carrier, gene expression, transporter balance, etc... It would get insanely messy for everyone.

If you have the courage and want to be super hardcore:
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0035955
It's by Hamann & friends

Then read this:
http://www.ncbi.nlm.nih.gov/pubmed/23581566

And this baby:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2860955/

You'll understand exactly how it works.


PS:
You seem to be motivated to do some research, I was thinking building a wiki for tinnitus, with the entire process with each step documented, we could do several level of complexity starting by super macro view and going into super deep details, would you be interested to help, or any science lover out there ? @jazz , @locoyeti , @attheedgeofscience , @dan, @rtwombly ,@Mpt ,@Zimichael others ?? :p
 
Wooooooooohaaaa.....I really should have been paying more attention in brain-psych' class, but back in 1970 it was just Skinner, Pavlov and rats anyhow. Glad some of you guys are conversant in the minutiae of this neuro-chemical axon membrane dance though. Please keep it coming.

My God what a list ATEOS...No wonder Quinine causes tinnitus! (Old colonial standby where I was from).

@dan thanks for the clarification about Trobalt 'being for sale but not for sale' in Canada. Gawd how goofy that is. Usually it's the USA that has the run-around rigmarole.
Also on the "free" aspect of no insurance and so forth, I wrote all this up back on July 29th. but will copy and paste here...However, not sure if GSK Canada will go for this if the drug is verboten there! Also don't know if GSK (or any of the Big Pharma companies have the same "Patient Assist" programs there as here...but don't see why not.

Here's the scoop for USA version from prior post...

OK FYI here's another way: I could get Potiga free from GlaxoSmithKlein right now if I did not have insurance drug coverage....which I now do c/o Obamacare!!!... A classic "Catch 22" as Potiga is not in my insurance company's formulary! Which is no surprise as there are scads of other safer anti-convulsants out there to choose from. And yes I already phoned Patient Assist at GSK, and no they do not give it away if you have any drug coverage insurance policy. Here's the links:http://www.gskforyou.com/ and https://www.bridgestoaccess.com/

For a smorgasbord site for any drug try these folks: https://www.pparx.org/en/prescription_assistance_programs

All the Big Pharma companies have these programs. I got stuff free from a number of them and one smaller company (Romark ~ makes Alinia an anti-parasitic) did not even want my 1040 tax form as proof of income! In some ways it's better to not have insurance! Weird I know.

Dan, remember though that 1. You have to have a prescription for the stuff, and 2. You generally have to show proof of "poorness" (which is ridiculously high in USA, like making under $32,000 or something) via a faxed copy of your annual tax return main page. No big hassle really.

Also, another thing relevant in my opinion, is plasma dose levels. For my size and weight (5' 8" and 135 pounds - post camping...Ha, ha) I don't need the 300 mg TID to get the same plasma concentration as Matt for instance. So my doses would be lower = cheaper, plus for sure as hell I think the pills can be cut.

Finally, I agree with the cautions about getting meds "offshore". My wife was Thai and we would get meds for next to nothing in Bangkok, but I'm not sure some of them were any good at all, as when I got the US made equivalents (c/o "Patient Assist") they seemed to be stronger or different. Plus there was a big study recently showing tons of junk meds made in India and China that were worthless garbage.

Ummmmmmmmmmmm....good luck. Zimichael
 
Hello there I have been following this thread with interest over the last few weeks and a question occurred to me which for those that may more be in the know may possibly have an answer in particular @benru who is doing some great work on the background of what Autofony are doing and hopefully fingers crossed how successful their drug could be.

My question relates to the last sentence in the link regarding what Autofony AU that @benru posted which says
'These results suggest that AUT3 has potential in the treatment of chronic tinnitus associated with noise-induced hearing loss.'
 
The article you mentionned is anterior to hamann/page findings as said by @rtwombly

Dude the answer to the glutamate thing is in the first quote, it's funny coz you're the second one I give it and who re-ask the same thing. :cat: No Rage :cat: (jk I don't mind to help!)

First link, page 11, just read the title it's what you want.
"KATP channels in glutamate mediated synaptic degeneration"

It's the echo of a very old article (1999 aka Tinnitus stone age):
http://www.ncbi.nlm.nih.gov/pubmed/10842598

Third link is also talking about the phenomenom in a more subtle manner. The thing is also you should not look for glutamate as a keyword but more VGLUT, but this is a very (very) complex mechanism you want to dig into. I don't want to introduce the notion of solute carrier, gene expression, transporter balance, etc... It would get insanely messy for everyone.

If you have the courage and want to be super hardcore:
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0035955
It's by Hamann & friends

Then read this:
http://www.ncbi.nlm.nih.gov/pubmed/23581566

And this baby:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2860955/

You'll understand exactly how it works.


PS:
You seem to be motivated to do some research, I was thinking building a wiki for tinnitus, with the entire process with each step documented, we could do several level of complexity starting by super macro view and going into super deep details, would you be interested to help, or any science lover out there ? @jazz , @locoyeti , @attheedgeofscience , @dan, @rtwombly ,@Mpt ,@Zimichael others ?? :p
Count me in as well. I'm keen to learn the science and following up to now.
 
Hello don't know what happened there but my question was going to be is that Autofony say that they are targeting tinnitus that has come about due to a hearing loss and I assume that does not matter how much loss that is but I wonder if it will still work after 3/4/5 years with tinnitus as looks as if they are originally aiming at the fairly newbies, what is your opinion on this particularly @benryu what do you think as if I am going to be like I am for the rest of my time it is going to be so very hard and I live in the hope that one day there may be a cure or at least a reduction for all ?

Thank you and sorry for the technical mishap
 
Hello don't know what happened there but my question was going to be is that Autofony say that they are targeting tinnitus that has come about due to a hearing loss and I assume that does not matter how much loss that is but I wonder if it will still work after 3/4/5 years with tinnitus as looks as if they are originally aiming at the fairly newbies, what is your opinion on this particularly @benryu what do you think as if I am going to be like I am for the rest of my time it is going to be so very hard and I live in the hope that one day there may be a cure or at least a reduction for all ?

Thank you and sorry for the technical mishap

Hey Freddie,

Yeah the drug is expected to work no matter the time frame, it may just take longer for older T., but it will work too.
They want new T. for their proof of concept, let's not forget they are a company first, they want spetacular & fast results so they go for recent T (easy mode).

I guarantee you won't have T. for all your life, research goes super fast at the moment, and there is a lot of evidence that the AUT00063 is a potential big winner.

Just a few years or maybe months for the lucky trialists before silencing t. :)
 
Hey Freddie,

Yeah the drug is expected to work no matter the time frame, it may just take longer for older T., but it will work too.
They want new T. for their proof of concept, let's not forget they are a company first, they want spetacular & fast results so they go for recent T (easy mode).

I guarantee you won't have T. for all your life, research goes super fast at the moment, and there is a lot of evidence that the AUT00063 is a potential big winner.

Just a few years or maybe months for the lucky trialists before silencing t. :)
It would be momentous. I do hope you are right. We'll have to have a "silent" party and all meet somewhere central - like GMT!!! Re the "easy mode" for drug companies - it was always been my hypothesis for AM101 - they took people with T < 3 months, as it would be easier for them to cure a T newbie, than someone that it had set in for years. However, after now reading your posts on glutamate blocking, it seems AM101 might only be useful in early onset, yet I am remaining hoping it will still have some effect in < 12. My money is also on AUT00063.
 
All of it! The summary of the their patent application can be found here; you will see that the text matches to the pdf document:

http://www.google.com/patents/WO2013083994A1?cl=en
"Hearing conditions, including tinnitus have a profound effect on the quality of life, causing social isolation, depression, work and relationship difficulties, low self-esteem, and prejudice." - I can relate!!

and

" Consequently, we propose that small molecule modulators of Kv3 channels in auditory brainstem nuclei could have a benefit in the treatment of disorders of hearing, including tinnitus and auditory hyper-acuity associated with Fragile X syndrome and autism.

The compounds of formula (I) may be used as medicaments, in particular for the prophylaxis or treatment of hearing disorders, including hearing loss and tinnitus, as well as schizophrenia, bipolar disorder, epilepsy and sleep disorders.

Further, there is provided a method for the prophylaxis or treatment of hearing disorders, including hearing loss and tinnitus, as well as schizophrenia, bipolar disorder, epilepsy and sleep disorders by administering to a subject a compound of formula (I).

Compounds of formula (I) may be used in the manufacture of a medicament for the prophylaxis or treatment of hearing disorders, including hearing loss and tinnitus, as well as schizophrenia, bipolar disorder, epilepsy and sleep disorders.

The compounds of formula (I) or their pharmaceutically acceptable salts may be of use for the treatment or prophylaxis of hearing disorders including auditory neuropathy, auditory processing disorder, hearing loss, which includes sudden hearing loss, noise induced hearing loss, substance- induced hearing loss, and hearing loss in adults over 60 (presbycusis), and tinnitus.

18. The compound according to claim 17, for use in the prophylaxis or treatment of hearing loss or tinnitus.
"

Thanks ATEOES - i found the match now. Anyone own a lab?

I am not sure what Product # would be from here though: http://www.sigmaaldrich.com/life-science/cell-biology/cell-biology-products.html?TablePage=9551103

Or again, is it all of them?
 
I am not sure what Product # would be from here though: http://www.sigmaaldrich.com/life-science/cell-biology/cell-biology-products.html?TablePage=9551103

Or again, is it all of them?

The weblink shows a fairly exhaustive listing of all currently available and purchasable potassium modulators (openers/blockers). You will with 100% certainty not find a single kv3.1-3.4 potassium modulator product listed on that page, because Autifony Therapeutics Ltd are first in class (and have a patent). The very closest I could find is a kv3.4 blocker (which is not what is needed here...).

Steve, best bet is to get involved in a clinical trial such as Autifony. People who are UK nationals are "real lucky" in that sense - as they are elligible for the trial. As a Dane, I was/am not allowed in either the AUT00063 nor AM101 clinical trial. "Playing around" with drugs is not a way to solve a tinnitus problem; your time would be better spent on trying to get into the upcoming clinical trial in my opinion.
 
The weblink shows a fairly exhaustive listing of all currently available and purchasable potassium modulators (openers/blockers). You will with 100% certainty not find a single kv3.1-3.4 potassium modulator product listed on that page, because Autifony Therapeutics Ltd are first in class (and have a patent). The very closest I could find is a kv3.4 blocker (which is not what is needed here...).

Steve, best bet is to get involved in a clinical trial such as Autifony. People who are UK nationals are "real lucky" in that sense - as they are elligible for the trial. As a Dane, I was/am not allowed in either the AUT00063 nor AM101 clinical trial. "Playing around" with drugs is not a way to solve a tinnitus problem; your time would be better spent on trying to get into the upcoming clinical trial in my opinion.
Agreed. However, not that easy to get on a trial :eek: Sorry to hear you didn't get on either. I don't have any intention to play around with drugs. My question was more from an inside perspective of what the drug looks like, it's chemical make-up , compounds etc for my own personal understandings. Thanks for the info.
 
Have there been any real evidence than AUT00063 works on humans, because I took once an experimental drug that showed 3 animal studies as working but had 100% opposite effect on me making it worse not better.
 
Have there been any real evidence than AUT00063 works on humans, because I took once an experimental drug that showed 3 animal studies as working but had 100% opposite effect on me making it worse not better.

No, they havent tried it on humans with T yet. The only "proof" we have that Autifony is on the right track is that Retigabine abolished Mpt's T, as seen in this thread. That give us some kind of hint that the answer to the mystery that is T, lays in the potassium channels. What kind of drugs did you try?
 
No, they havent tried it on humans with T yet.

I would have to disagree as AUT00063 is now in phase II (shortly, at least).
 
No, they havent tried it on humans with T yet. The only "proof" we have that Autifony is on the right track is that Retigabine abolished Mpt's T, as seen in this thread. That give us some kind of hint that the answer to the mystery that is T, lays in the potassium channels. What kind of drugs did you try?

One single person getting better is not any proof at all, I mean I know people whose tinnitus got better over time etc, some people have psychosomatic stuff, some have it for years and than it dissapears than reappears later for on reason that is obvious. I mean did even mpt test how he is doing without retigabine? This is all kinda on very weak footing and I have seen a lot of just plain wrong conclusioned science before. They say x makes a effect while b is opposite and than x has b effect.
 
One single person getting better is not any proof at all, I mean I know people whose tinnitus got better over time etc, some people have psychosomatic stuff, some have it for years and than it dissapears than reappears later for on reason that is obvious. I mean did even mpt test how he is doing without retigabine? This is all kinda on very weak footing and I have seen a lot of just plain wrong conclusioned science before. They say x makes a effect while b is opposite and than x has b effect.

That's why I said "proof", not proof.
 
Phase 1 was for healthy humans without T only. Phase 2 hasnt begun yet.

It might be stated somewhere, and I'm sorry for asking if that's the case, but from what I understand there were NO side effects during the phase 1 trials of AUT00063, and subjects did show signs of the medicine "reaching" the potasium channels but not altering them (because there was no need in healthy subjects), is this correct? Also, how long did these subjects take the medicine for? Weeks? Months?
 
Phase 1 was for healthy humans without T only. Phase 2 hasnt begun yet.

I certainly can't blame anyone for sticking to the official releases that Autifony has made, but even their official communication is a little shakey in that respect. Here is something a little more concrete from another article:

"Also on the preclinical side, Autifony has a relationship with the Ear Institute at University College London (UCL), where work on animal models is in progress currently. UCL is in the process of setting up a unit to carry out Phase I clinical trials of treatments for hearing disorders and Large said it is hoped they will collaborate on clinical development also. Within the scope of the 10 million first round funding the lead product will be progressed to the end of Phase I. Large said that the initial clinical studies will involve patients, meaning that it should be possible to get some early indications of efficacy."

Phase I trials will almost always have to involve patients one way or another, because they will need to get early indications of efficacy dosages too.
 
It might be stated somewhere, and I'm sorry for asking if that's the case, but from what I understand there were NO side effects during the phase 1 trials of AUT00063, and subjects did show signs of the medicine "reaching" the potasium channels but not altering them (because there was no need in healthy subjects), is this correct? Also, how long did these subjects take the medicine for? Weeks? Months?

This is a valid and good question. I don't know the answer to your question, but I believe that restoration of the of potassium gate can be achieved without having to take the medication forever. My take is that there will be a treatment window which will vary from patient to patient before a satisfactory level of correction has been achieved. Perhaps minimum treatment duration will be eg. 4 weeks and maximum eg. 8 weeks (meaning any treatment beyond that point will not bring about any further benefit). That's my guess. But, I don't know. And if you had asked me half a year ago, I would have said that this kind of medication would need to be taken for life.

Again, I must stress that I hate to speculate. I would much rather get the facts from the people who know.
 
I feel like we're going a little bit off topic here with the Autifony talk.

@Philip83
I have no idea, sorry. Altough I can't imagine that the drug havent got any side effects at all.

@attheedgeofscience
Well how about that. Too bad they havent shared any of the results from that little experiment.
 
Because it's been a rather loud day, I wanted to cheer myself up with research! Something interesting happens when you Google Autifony's "Charles Large" and retigabine. Maybe it's been mentioned on here before and I just missed it, but Dr. Large was co-author of one of the authoritative articles on RTG back in 2012. So he seems to have walked the same road we're on in this thread. He saw the potential of RTG and pursued its logical conclusions, all the time trying to find a safer version of the drug.
 
@rtwombly ...yeah, cool! Seems like that from a quick perusal though mainly "seizure" aspects stick out.

Hey an aside question for the not-to-be bromancer @benryu (yeah I'm pretty 'mundane hetero normal' re anything but esoteric illnesses, goofing around on stage, and such)...Am I missing something here re the whole Glutamine precursor damage crap that happens before the K channel gets screwed??? I mean if it's the excitation c/o of Glut.' that causes the damage, that causes the K burp, that cause the T...(simplified tremendously :)), then why not use big time Benzos saturation to treat acute T right away (Glut.' killers) rather than Prednisolone, etc.???

And yeah, I think your idea to do a decent Wiki write up on T and how it happens, in various degrees of complexity, would be great!!! Especially as the ATA and ENT versions are so lame (or were when I last looked). However, I'm not as sharp a whistle as a lot of you guys but could sure "assess" for "readability" to say where the equivalent Shakespearean "everyman" would lose it and go glassy-eyed. I mainly have street cred with T and H, but not so much the up to date brain tech stuff. (My specialty is actually the 'gut' rather than neuroscience stuff).

Best, Zimichael
 
Benzos only act on GABA receptors, not Glutamate.
I believe Dr.Shulman has a Klonopin saturation protocol immediately after tinnitus onset, but it is not effective in most cases, otherwise it would be a standard protocol.
 
What I don't understand is why does AUT00063 target the Kv3 channels if Retigabine works targetting the Kv7 channels? I have a hard time explaining this to my doctor.
 
How you feeling Mpt still going strong

yep-- went tan office party to whirlyball-- a go-kart/lacrosse type game that we have here in the states- loud, indoor track, 80's - def leperdish rock blaring from speakers-- probably 85db or so-- was there for two hours- no reactivinty, no tinnitus sounds afterwards last night or today-- I basically feel like a normal, pre-tinnitus human again
 

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