Can chronopharmacology improve the therapeutic management of neurological diseases?

Fundam Clin Pharmacol. 2021 Jun;35(3):564-581. doi: 10.1111/fcp.12659. Epub 2021 Mar 1.

Abstract

The importance of circadian rhythm dysfunctions in the pathophysiology of neurological diseases has been highlighted recently. Chronopharmacology principles imply that tailoring the timing of treatments to the circadian rhythm of individual patients could optimize therapeutic management. According to these principles, chronopharmacology takes into account the individual differences in patients' clocks, the rhythmic changes in the organism sensitivity to therapeutic and side effects of drugs, and the predictable time variations of disease. This review examines the current literature on chronopharmacology of neurological diseases focusing its scope on epilepsy, Alzheimer and Parkinson diseases, and neuropathic pain, even if other neurological diseases could have been analyzed. While the results of the studies discussed in this review point to a potential therapeutic benefit of chronopharmacology in neurological diseases, the field is still in its infancy. Studies including a sufficiently large number of patients and measuring gold standard markers of the circadian rhythmicity are still needed to evaluate the beneficial effect of administration times over the 24-hour day but also of clock modulating drugs.

Keywords: chronopharmacology; circadian rhythm; neurological diseases.

Publication types

  • Review

MeSH terms

  • Alzheimer Disease / drug therapy
  • Alzheimer Disease / physiopathology
  • Circadian Rhythm
  • Drug Administration Schedule
  • Drug Chronotherapy*
  • Epilepsy / drug therapy
  • Epilepsy / physiopathology
  • Humans
  • Nervous System Diseases / drug therapy*
  • Nervous System Diseases / physiopathology*
  • Neuralgia / drug therapy
  • Neuralgia / physiopathology
  • Parkinson Disease / drug therapy
  • Parkinson Disease / physiopathology
  • Suprachiasmatic Nucleus / metabolism