Therapy target
- Relief of symptoms
Therapy recommendations
- Episodic ataxia type 2 (EA2): fampirdine (4-aminopyridine; drug from the group of reversible potassium channel blockers) to reduce the frequency of ataxias; the same applies to acetazolamide and carbamazepine
- Ataxias of mixed etiology: riluzole (drug belongs to the benzothiazole group)100 mg/d.
- Spinocerebellar ataxias (SCA) and Friedreich’s ataxia: riluzole (as a therapeutic trial in the context of an individual therapeutic trial* ; probably effective); possibly also valproate (drug belongs to the group of anticonvulsants) 1,200 mg/d (weak evidence).
- Spinocerebellar degeneration: thyrotropin-releasing hormone (TRH; peptide hormone produced as a releasing hormone in the hypothalamus) (may relieve some ataxia symptoms).
* After applying for coverage by health insurance.
Note: Red-hand letter (AkdÄ Drug Safety Mail): contraindications, warnings, and measures to avoid exposure to valproate during pregnancy:
- In girls and women of childbearing age, valproate should be used only if other treatments are not effective or are not tolerated.
- Valproate is contraindicated in women of childbearing age unless the pregnancy prevention program is followed.
- Valproate is contraindicated in epilepsy during pregnancy unless no suitable alternatives are available.
- Valproate is contraindicated during pregnancy for bipolar disorder and migraine prophylaxis.
