Certain foods and specific drugs have been linked to epilepsy in the literature. Here, we query PubMed citations for the co-occurrence of epilepsy with foods and drugs, using a list of 217,776 molecules from the HMDB. Notably, the top associations with epilepsy include approved drugs and drug families, diagnostic markers, inducers, and vitamins. Drugs include fosphenytoin (40%), topiramate (37%), valproic acid (34%), hydantoin (20%), phenytoin (31%), carbamazepine (33%), carbamazepine-10,11-epoxide (40%), trimethadione (31%), gabapentin (14%), pregabalin (11%), flunarizine (7%), fenfluramine (4%), bumetanide (4%), KBr (18%), cannabidiol (14%), clonazepam (22%), nitrazepam (10%), diazepam (7%), lorazepam (6%), midazolam (3%), amobarbital (21%), phenobarbital (16%), flumazenil (7%) allopregnanolone (7%), pregnanolone (6%), epipregnanolone (6%), 3-hydroxypregnan-20-one (6%), and vitamin B6 (6%). Drug families and scaffolds include imidazolidine (18%), succinimide (10%), acetamide (7%), 2-pyrrolidinone (7%), pyrrolidine (6%), tetrahydropyridine (6%), and isoxazole (4%). Investigational compounds include cyano-7-nitroquinoxaline-2,3-dione (5%). Diagnostic markers include exametazime (10%) and quinolinic acid (3%). Inducers include flurothyl (37%), pentetrazol (32%), pilocarpine (25%), (+)-Bicuculline (8%), and 1-methyl-4-phenyl-1,2,5,6-tetrahydropyridine (MPTP, 6%). Our analysis highlights frequently cited associations between epilepsy and specific drugs and highlights the importance of supplementing nutrients with vitamin B6 and the ketogenic diet, which increases the gamma-aminobutyric acid (GABA)/glutamate ratio. As such, our study offers dietary approaches in the treatment of this neurodegenerative disease.

BACKGROUND Long-term use of proton pump inhibitors (PPIs) has been associated with potential adverse effects, including an increased risk of gastric cancer. Despite widespread use awareness of these risks among physicians varies considerably. Understanding physicians’ perceptions and prescribing behaviors is critical to improving patient safety and promoting evidence-based practices. This study aimed to assess the level of awareness and risk perception among gastroenterologists and non-gastroenterologists regarding prolonged PPI use and its association with gastric malignancy. AIM To assess physicians’ awareness of gastric cancer risk associated with long-term PPI use and compare perceptions between specialties. METHODS A cross-sectional observational study was conducted among 33 physicians (15 gastroenterologists and 18 non-gastroenterologists) in Israel. Participants completed a structured questionnaire evaluating knowledge, attitudes, and prescribing behaviors related to PPI use. Data were analyzed using descriptive statistics and nonparametric tests to assess differences between groups and correlation patterns. Ethical approval and informed consent were obtained. RESULTS Gastroenterologists demonstrated significantly higher awareness of the potential gastric cancer risks linked to prolonged PPI use (mean awareness score: 6.9 ± 1.2) compared with non-gastroenterologists (4.1 ± 1.3, P < 0.01). Despite their awareness 80% of gastroenterologists reported frequent long-term prescribing. Nonparametric correlation analysis revealed associations between specialty, knowledge level, and prescribing habits. Several misconceptions about cancer risk mechanisms were identified across specialties. CONCLUSION Physician awareness regarding gastric cancer risk of long-term PPI use remains inconsistent, especially among non-specialists, emphasizing the need for targeted educational programs and clearer prescribing guidelines.

BACKGROUND Long-term proton pump inhibitor (PPI) therapy is widely prescribed for acid-related disorders. Emerging evidence associates prolonged use with potential adverse outcomes, including gastric cancer. Despite increasing prescriptions, little is known about patients’ awareness of these risks or factors influencing discontinuation. We hypothesized that limited risk awareness and family support significantly affect patients’ willingness to deprescribe PPIs. AIM To evaluate patients’ awareness of PPI risks and factors associated with deprescribing. METHODS A cross-sectional observational study was conducted in community clinics and pharmacies across Israel, including 3000 adult PPI users recruited consecutively. Participants completed a multilingual survey (Hebrew, Arabic, Russian) assessing risk awareness, family support, and quality of life. A composite risk scale (0-12) was used to quantify perceived cancer risk. Descriptive statistics and multivariate logistic regression were performed to identify factors associated with high-risk awareness and willingness to discontinue PPIs. RESULTS Among 3000 participants, fatigue occurred in 20%, constipation in 31.3%, infections in 9.3%, renal issues in 4.6%, and no side effects in 12.5%. Pantoprazole cancer-risk perception was 26.5%. Overall, 30% desired to discontinue PPIs and 15% reported symptom recurrence. High composite risk score (≥ 2) was associated with family support [odds ratio (OR) = 1.9, 95% confidence interval (CI): 1.3-2.8; P < 0.01] and longer PPI use (> 1 year; OR = 1.6, 95%CI: 1.1-2.4; P = 0.02). Attempted discontinuation correlated with high-risk score (OR = 2.1, 95%CI: 1.5-3.0; P < 0.001). CONCLUSION Patients show limited awareness of long-term PPI risks. Family support and longer treatment duration are strongly associated with higher risk awareness and willingness to discontinue PPIs.