Calcitonin potentiates the anticonvulsant and antinociceptive effects of valproic acid and pregabalin in pentylenetetrazole-kindled mice

Antiepileptic drugs are the backbone for epilepsy management. Epilepsy may be accompanied by decreased pain threshold. Thus, anticonvulsant agents with antinociceptive properties are of great importance. This study investigated the possible anticonvulsant and antinociceptive effects of calcitonin in combination with either valproic acid or pregabalin and whether these effects might occur through γ-aminobutyric acid (GABA) modulation. Eighty-four male Balb/C mice were divided into 7 groups: control-naïve, pentylenetetrazole (PTZ)-induced seizures, PTZ-calcitonin, PTZ-valproic acid, PTZ-pregabalin, PTZ-calcitonin-valproic acid (PCV) combination, and PTZ-calcitonin-pregabalin (PCP) combination. PTZ was used in a sub-convulsive dosage, every other day for 11 injections. Drugs were given i.p. 30min before PTZ. After each PTZ injection, mice were put under observation and PTZ-provoked seizures were assessed. After the last dose of PTZ, the hot plate test was used to assess antinociceptive properties. Also, brain GABA neurotransmitter was evaluated by immunoassay. Repeated injection of PTZ induced chemical kindling. Calcitonin was found to have significant antinociceptive property as shown by hot plate latency. The beneficial effects of PCV and PCP combination were statistically significant in epilepsy and pain models as compared to valproic acid and pregabalin. The antiepileptic and antinociceptive activity of calcitonin may not relate to the GABAergic system. Calcitonin enhanced the anticonvulsant and antinociceptive effects of either valproic acid or pregabalin. This new treatment "calcitonin add-on" may provide an improved range of options for patients with refractory epilepsy which is still an important risk factor for sudden death.