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101-408: Secobarbital is used for managing symptoms of epilepsy and for short-term treatment of insomnia . It is also used as a preoperative medication to produce anesthesia and anxiolysis for short surgical, diagnostic, or therapeutic procedures which are minimally painful. Secobarbital was widely abused for recreational purposes in the 1960s, 1970s, and 1980s, and accidental overdose was associated with

202-405: A single gene defect (1–2%); most are due to the interaction of multiple genes and environmental factors. Each of the single gene defects is rare, with more than 200 in all described. Most genes involved affect ion channels , either directly or indirectly. These include genes for ion channels, enzymes , GABA , and G protein-coupled receptors . In identical twins , if one is affected, there

303-588: A Mexican generic drug company. In December 2009, Valeant announced its Canadian subsidiary would acquire Laboratoire Dr. Renaud, for C$ 23 million. In March 2010, Valeant announced its acquisition of a Brazilian generics and over-the-counter company for $ 28 million and manufacturing plant for a further $ 28 million. In April 2010, Valeant announced that its Canadian subsidiary would acquire Vital Science Corp. for C$ 10.5 million. In May 2010, Valeant acquired Aton Pharmaceuticals for $ 318 million. On September 28, 2010, Valeant merged with Biovail . The company retained

404-426: A consequence of other health problems; if they occur right around a specific cause, such as a stroke, head injury, toxic ingestion, or metabolic problem, they are known as acute symptomatic seizures and are in the broader classification of seizure-related disorders rather than epilepsy itself. Genetics is believed to be involved in the majority of cases, either directly or indirectly. Some epilepsies are due to

505-402: A contraction of the limbs followed by their extension and arching of the back which lasts 10–30 seconds (the tonic phase). A cry may be heard due to contraction of the chest muscles , followed by a shaking of the limbs in unison (clonic phase). Tonic seizures produce constant contractions of the muscles. A person often turns blue as breathing is stopped. In clonic seizures there is shaking of

606-752: A dermatology unit of Sanofi . In January 2012, Valeant acquired Brazilian sports nutrition company Probiotica for R$ 150 million. In February 2012, Valeant acquired ophthalmic biotechnology company Eyetech Inc. In April 2012, Valeant acquired Pedinol. In April 2012, Valeant acquired assets from Atlantis Pharma in Mexico for $ 71 million. In May 2012, Valeant acquired AcneFree for $ 64 million plus milestone payments. In June 2012, Valeant acquired OraPharma for approximately $ 312 million with up to $ 144 million being paid in milestone payments. In August 2012, Valeant agreed to buy skin-care company Medicis Pharmaceutical for $ 2.6 billion. In January 2013, Valeant acquired

707-495: A dissociative disorder. Myoclonic seizures involve very brief muscle spasms in either a few areas or all over. These sometimes cause the person to fall, which can cause injury. Absence seizures can be subtle with only a slight turn of the head or eye blinking with impaired consciousness; typically, the person does not fall over and returns to normal right after it ends. Atonic seizures involve losing muscle activity for greater than one second, typically occurring on both sides of

808-701: A doctor, followed by a muscle relaxant . As of 2010, only 15% of those who died by physician-assisted suicide opted for orally consuming the lethal drug(s), the rest choosing to have the drugs administered intravenously by a doctor instead. In the United States, secobarbital and pentobarbital are the most common drugs prescribed under physician aid-in-dying laws in Oregon since 1998, Washington since 2008, and Vermont since 2013. Ranbaxy Laboratories Limited previously experienced various issues in their attempts to produce 100 mg secobarbital capsules. In 2017, secobarbital

909-541: A group of multisystemic diseases that most prominently affect the skin and central nervous system. They are caused by defective development of the embryonic ectodermal tissue that is most often due to a single genetic mutation. The brain, as well as other neural tissue and the skin, are all derived from the ectoderm and thus defective development may result in epilepsy as well as other manifestations such as autism and intellectual disability. Some types of phakomatoses such as tuberous sclerosis complex and Sturge-Weber syndrome have

1010-461: A group of neurons begin firing in an abnormal, excessive, and synchronized manner. This results in a wave of depolarization known as a paroxysmal depolarizing shift . Normally, after an excitatory neuron fires it becomes more resistant to firing for a period of time. This is due in part to the effect of inhibitory neurons, electrical changes within the excitatory neuron, and the negative effects of adenosine . Focal seizures begin in one area of

1111-484: A higher prevalence of epilepsy relative to others such as neurofibromatosis type 1 . Tuberous sclerosis complex is an autosomal dominant disorder that is caused by mutations in either the TSC1 or TSC2 gene and it affects approximately 1 in 6,000–10,000 live births. These mutations result in the upregulation of the mechanistic target of rapamycin (mTOR) pathway which leads to the growth of tumors in many organs including

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1212-481: A path of strategic sales, debt reduction, and organic growth. By January 2017, the company had sold its skincare brands to L'Oréal for $ 1.3 billion and its Dendreon biotech unit to Sanpower for $ 819.9 million. In June, the company sold iNova Pharmaceuticals for $ 910 million. In July, the company also divested Obagi Medical Products for $ 190 million. In November, it announced it would sell Sprout Pharmaceuticals back to its original owners, two years after acquiring

1313-545: A result of several other conditions, including tumors, strokes, head trauma, previous infections of the central nervous system , genetic abnormalities, and as a result of brain damage around the time of birth. Of those with brain tumors, almost 30% have epilepsy, making them the cause of about 4% of cases. The risk is greatest for tumors in the temporal lobe and those that grow slowly. Other mass lesions such as cerebral cavernous malformations and arteriovenous malformations have risks as high as 40–60%. Of those who have had

1414-411: A seizure, the classification of epilepsies focuses on the underlying causes. When a person is admitted to hospital after an epileptic seizure the diagnostic workup results preferably in the seizure itself being classified (e.g. tonic-clonic) and in the underlying disease being identified (e.g. hippocampal sclerosis ). The name of the diagnosis finally made depends on the available diagnostic results and

1515-414: A specific area from which seizures may develop, known as a "seizure focus". Another mechanism of epilepsy may be the up-regulation of excitatory circuits or down-regulation of inhibitory circuits following an injury to the brain. These secondary epilepsies occur through processes known as epileptogenesis . Failure of the blood–brain barrier may also be a causal mechanism as it would allow substances in

1616-481: A specific length of time. The word epilepsy is from Ancient Greek ἐπιλαμβάνειν , 'to seize, possess, or afflict'. Epilepsy is characterized by a long-term risk of recurrent epileptic seizures . These seizures may present in several ways depending on the parts of the brain involved and the person's age. The most common type (60%) of seizures are convulsive which involve involuntary muscle contractions. Of these, one-third begin as generalized seizures from

1717-403: A stroke, 6–10% develop epilepsy. Risk factors for post-stroke epilepsy include stroke severity, cortical involvement, hemorrhage and early seizures.  Between 6 and 20% of epilepsy is believed to be due to head trauma. Mild brain injury increases the risk about two-fold while severe brain injury increases the risk seven-fold. In those who have experienced a high-powered gunshot wound to

1818-489: A supplier of eye health products. Bausch Health's business model is primarily focused on acquiring small pharmaceutical companies and then sharply increasing the prices of the drugs these companies sell. Valeant was originally founded in 1959, as ICN Pharmaceuticals by Milan Panić in California. During the 2010s, Valeant adopted a strategy of buying up other pharmaceutical companies which manufactured effective medications for

1919-578: A variety of medical problems, and then increasing the price of those medications. As a result, the company grew rapidly and in 2015 was the most valuable company in Canada. Valeant was involved in a number of controversies surrounding drug price hikes and the use of a specialty pharmacy for the distribution of its drugs. This led to an investigation by the U.S. Securities and Exchange Commission , causing its stock price to plummet more than 90 percent from its peak, while its debt surpassed $ 30 billion. In July 2018,

2020-420: Is 75-100% and is higher in those with bilateral involvement. Seizures typically occur within the first two years of life and are refractory in nearly half of cases. However, high rates of seizure freedom with surgery have been reported in as many as 83%. Neurofibromatosis type 1 is the most common phakomatoses and occurs in approximately 1 in 3,000 live births. It is caused by autosomal dominant mutations in

2121-544: Is a 50–60% chance that the other will also be affected. In non-identical twins, the risk is 15%. These risks are greater in those with generalized rather than focal seizures. If both twins are affected, most of the time they have the same epileptic syndrome (70–90%). Other close relatives of a person with epilepsy have a risk five times that of the general population. Between 1 and 10% of those with Down syndrome and 90% of those with Angelman syndrome have epilepsy. Phakomatoses , also known as neurocutaneous disorders, are

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2222-410: Is a white hygroscopic powder that is soluble in water and ethanol. While generic versions of the drug were in existence after Eli Lilly's patent on Seconal expired, currently there are no companies that manufacture the drug generically in the United States. Until 2020, Valeant was the sole marketer of Seconal in the United States. As of 2021, Valeant discontinued the product, and Bausch Health became

2323-562: Is abruptly ended and can include: Ranbaxy Pharmaceuticals , an India-based company now predominantly owned by the Japanese company Daiichi Sankyo , obtained the rights to market and to use the trade name Seconal from Eli Lilly in 1998 and did so until September 2008. The actual manufacturer of Seconal subsequent to the time Eli Lilly manufactured the drug was Ohm Pharmaceuticals, a wholly owned subsidiary of Ranbaxy. The rights to market Seconal were then sold to Marathon Pharmaceuticals, which became

2424-593: Is believed to play an important role in epilepsies by a number of mechanisms. Simple and complex modes of inheritance have been identified for some of them. However, extensive screening have failed to identify many single gene variants of large effect. More recent exome and genome sequencing studies have begun to reveal a number of de novo gene mutations that are responsible for some epileptic encephalopathies, including CHD2 and SYNGAP1 and DNM1 , GABBR2 , FASN and RYR3 . Syndromes in which causes are not clearly identified are difficult to match with categories of

2525-616: Is evidence that both depression and anxiety disorders are underdiagnosed and undertreated in people with epilepsy. Epilepsy can have both genetic and acquired causes, with the interaction of these factors in many cases. Established acquired causes include serious brain trauma, stroke, tumours, and brain problems resulting from a previous infection. In about 60% of cases, the cause is unknown. Epilepsies caused by genetic , congenital , or developmental conditions are more common among younger people, while brain tumors and strokes are more likely in older people. Seizures may also occur as

2626-500: Is more common at the extremes of age – in younger children and in older children and young adults due to differences in the frequency of the underlying causes. About 5–10% of people will have an unprovoked seizure by the age of 80. The chance of experiencing a second seizure within two years after the first is around 40%. In many areas of the world, those with epilepsy either have restrictions placed on their ability to drive or are not permitted to drive until they are free of seizures for

2727-758: Is not the main feature (e.g. Angelman syndrome) were categorized symptomatic but it was argued to include these within the category idiopathic . Classification of epilepsies and particularly of epilepsy syndromes will change with advances in research. Valeant Pharmaceuticals Bausch Health Companies Inc. (formerly Valeant Pharmaceuticals International, Inc.) is an American-Canadian multinational specialty pharmaceutical company based in Laval, Quebec , Canada. It develops, manufactures and markets pharmaceutical products and branded generic drugs , primarily for skin diseases , gastrointestinal disorders , eye health and neurology . Bausch Health owns Bausch & Lomb ,

2828-508: Is often pursued. Sturge-Weber syndrome is caused by an activating somatic mutation in the GNAQ gene and it affects approximately 1 in 20,000–50,000 live births. The mutation results in vascular malformations affecting the brain, skin and eyes. The typical presentation includes a facial port-wine birthmark, ocular angiomas and cerebral vascular malformations which are most often unilateral but are bilateral in 15% of cases. The prevalence of epilepsy

2929-406: Is perfectly allowable, so long as it is clear what definition is being used. The ILAE definition for one seizure needs an understanding of projecting an enduring predisposition to the generation of epileptic seizures. WHO, for instance, chooses to just use the traditional definition of two unprovoked seizures. In contrast to the classification of seizures which focuses on what happens during

3030-568: Is relatively common, occurring in 6–10% of people. Often people do not remember what happened during this time. Localized weakness, known as Todd's paralysis , may also occur after a focal seizure. It would typically last for seconds to minutes but may rarely last for a day or two. Epilepsy can have adverse effects on social and psychological well-being. These effects may include social isolation, stigmatization, or disability. They may result in lower educational achievement and worse employment outcomes. Learning disabilities are common in those with

3131-498: Is supporting an investigator-initiated Phase 2 study of Relistor . The drug is intended for patients with resectable squamous cell carcinoma of the head and neck. In July 2023, 404 Media reported that Bausch Health had been hacked and 1.6 million registration numbers that are issued by the United States' Drug Enforcement Administration to healthcare providers for the prescription of controlled substances were stolen and being used for ransom. Cybersecurity firm Mandiant attributed

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3232-558: Is thought that the relationship between epilepsy and psychiatric disorders is not unilateral but rather bidirectional. For example, people with depression have an increased risk for developing new-onset epilepsy. The presence of comorbid depression or anxiety in people with epilepsy is associated with a poorer quality of life, increased mortality, increased healthcare use and a worse response to treatment (including surgical). Anxiety disorders and depression may explain more variability in quality of life than seizure type or frequency. There

3333-426: Is unknown, but a little is known about its cellular and network mechanisms. However, it is unknown under which circumstances the brain shifts into the activity of a seizure with its excessive synchronization . In epilepsy, the resistance of excitatory neurons to fire during this period is decreased. This may occur due to changes in ion channels or inhibitory neurons not functioning properly. This then results in

3434-534: The International League Against Epilepsy published new uniform guidelines for the classification of seizures as well as epilepsies along with their cause and comorbidities. People with epilepsy may experience seizure clusters which may be broadly defined as an acute deterioration in seizure control. The prevalence of seizure clusters is uncertain given that studies have used different definitions to define them. However, estimates suggest that

3535-515: The Neurofibromin 1 gene. Clinical manifestations are variable but may include hyperpigmented skin marks, hamartomas of the iris called Lisch nodules , neurofibromas , optic pathway gliomas and cognitive impairment. The prevalence of epilepsy is estimated to be 4–7%. Seizures are typically easier to control with anti-seizure medications relative to other phakomatoses but in some refractory cases surgery may need to be pursued. Epilepsy may occur as

3636-702: The U.S. Attorney's Office for the District of Massachusetts and the United States Attorney for the Southern District of New York in regards to an investigation on Valeant's "drug pricing, distribution and patient assistance program." The House Oversight Committee also requested documents from Valeant amid public concern around drug prices. In October 2015, the Federal Trade Commission began an investigation into Valeant's increasing control of

3737-421: The neurons . The occurrence of two or more unprovoked seizures defines epilepsy. The occurrence of just one seizure may warrant the definition (set out by the International League Against Epilepsy ) in a more clinical usage where recurrence may be able to be prejudged. Epileptic seizures can vary from brief and nearly undetectable periods to long periods of vigorous shaking due to abnormal electrical activity in

3838-712: The House's Committee on Oversight and Reform, and had received document requests from the Autorite de Marches Financiers in Canada and the New Jersey State Bureau of Securities." In January 2016, presidential candidate Hillary Clinton said she would be "going after" Valeant for its price hikes, causing its stock price to fall 9 percent on the New York Stock Exchange . On April 27, 2016, Bill Ackman, J. Michael Pearson, and Howard Schiller were forced to appear before

3939-567: The ILAE Commission for Classification of the Epilepsies addressed this issue and divided epilepsies into three categories (genetic, structural/metabolic, unknown cause) which were refined in their 2011 recommendation into four categories and a number of subcategories reflecting recent technological and scientific advances. Cases of epilepsy may be organized into epilepsy syndromes by the specific features that are present. These features include

4040-460: The Russian company Natur Produkt for $ 163 million. In March 2013, Valeant acquired Obagi Medical Products, Inc. In May 2013, the company acquired Bausch & Lomb from Warburg Pincus for $ 8.7 billion in a move to dominate the market for specialty contact lenses and related products. In January 2014, Valeant acquired Solta Medical for approximately $ 250 million. In May 2014, Nestle acquired

4141-592: The SEC $ 100,000 and $ 75,000, respectively. Following Ackman's exit, Paulson & Co. increased its stake in the company, became its largest shareholder, with its founder, John Paulson , joining the board, and vowing to rebuild the company's core franchises and to reduce its debt. In May 2022, Papa was replaced by Thomas Appio as the company's chief executive officer. Paulson replaced Papa as chairman of Bausch Health after being on its board of directors from June 2017 to May 2022. In May 2023, Judge Richard G. Andrews upheld

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4242-584: The United States Senate Special Committee on Aging to answer to concerns about the repercussions for patients and the health care system faced with Valeant's business model. By April 2016, the market value of hedge fund holdings in Valeant had fallen by $ 7.3 billion. Hedge fund herding continued to incite hedge fund portfolio managers to continue to buy Valeant shares. From 2015 to 2017, Valeant shares plummeted more than 90 percent. This

4343-432: The Valeant name and J. Michael Pearson as CEO, but was incorporated in Canada and temporarily kept Biovail's headquarters. Setting on a path of aggressive acquisitions, Pearson ultimately turned Valeant into a platform company that grows by systematically acquiring other companies. In February 2011, Valeant acquired PharmaSwiss S.A. for €350 million. In May 2011, former Biovail Corporation Chairman and CEO Eugene Melnyk

4444-549: The Wegman's School of Pharmacy curriculum, "red hearts". A less common nickname is "dolls"; this was partly responsible for the title of Jacqueline Susann 's novel Valley of the Dolls , whose main characters use secobarbital and other such drugs. Actresses Carole Landis , Judy Garland , playwright Tennessee Williams , and journalist Dorothy Kilgallen allegedly either died by suicide or of accidentally overdosing on secobarbital. Seconal

4545-403: The active portion of a seizure (the ictal state) there is typically a period of recovery during which there is confusion, referred to as the postictal period, before a normal level of consciousness returns. It usually lasts 3 to 15 minutes but may last for hours. Other common symptoms include feeling tired, headache , difficulty speaking, and abnormal behavior. Psychosis after a seizure

4646-994: The age that seizures begin, the seizure types, EEG findings, among others. Identifying an epilepsy syndrome is useful as it helps determine the underlying causes as well as what anti-seizure medication should be tried. The ability to categorize a case of epilepsy into a specific syndrome occurs more often with children since the onset of seizures is commonly early. Less serious examples are benign rolandic epilepsy (2.8 per 100,000), childhood absence epilepsy (0.8 per 100,000) and juvenile myoclonic epilepsy (0.7 per 100,000). Severe syndromes with diffuse brain dysfunction caused, at least partly, by some aspect of epilepsy, are also referred to as developmental and epileptic encephalopathies. These are associated with frequent seizures that are resistant to treatment and cognitive dysfunction, for instance Lennox–Gastaut syndrome (1–2% of all persons with epilepsy), Dravet syndrome (1: 15000-40000 worldwide ), and West syndrome(1–9: 100000 ). Genetics

4747-409: The alarming nature of their symptoms. The underlying mechanism of an epileptic seizure is excessive and abnormal neuronal activity in the cortex of the brain , which can be observed in the electroencephalogram (EEG) of an individual. The reason this occurs in most cases of epilepsy is unknown ( cryptogenic ); some cases occur as the result of brain injury , stroke, brain tumors , infections of

4848-468: The applied definitions and classifications (of seizures and epilepsies) and its respective terminology. The International League Against Epilepsy (ILAE) provided a classification of the epilepsies and epileptic syndromes in 1989 as follows: This classification was widely accepted but has also been criticized mainly because the underlying causes of epilepsy (which are a major determinant of clinical course and prognosis) were not covered in detail. In 2010

4949-412: The average retail price per 100 mg capsule had risen to over thirty dollars. Since its acquisition of the trade name, Valeant Pharmaceuticals made little, if any, change to the pricing of Seconal. Despite the price increases implemented by Marathon Pharmaceuticals, Seconal was still manufactured by Ohm. In the United States, Seconal is available only in 100 mg capsules, as a sodium salt . The salt

5050-439: The blood to enter the brain. There is evidence that epileptic seizures are usually not a random event. Seizures are often brought on by factors (also known as triggers) such as stress, excessive alcohol use , flickering light, or a lack of sleep, among others. The term seizure threshold is used to indicate the amount of stimulus necessary to bring about a seizure; this threshold is lowered in epilepsy. In epileptic seizures

5151-573: The body. Rarer seizure types can cause involuntary unnatural laughter (gelastic), crying (dyscrastic), or more complex experiences such as déjà vu . About 6% of those with epilepsy have seizures that are often triggered by specific events and are known as reflex seizures . Those with reflex epilepsy have seizures that are only triggered by specific stimuli. Common triggers include flashing lights and sudden noises. In certain types of epilepsy, seizures happen more often during sleep , and in other types they occur almost only when sleeping. In 2017,

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5252-531: The brain and performing blood tests . Epilepsy can often be confirmed with an EEG, but a normal reading does not rule out the condition. Epilepsy that occurs as a result of other issues may be preventable. Seizures are controllable with medication in about 69% of cases; inexpensive anti-seizure medications are often available. In those whose seizures do not respond to medication; surgery , neurostimulation or dietary changes may be considered. Not all cases of epilepsy are lifelong, and many people improve to

5353-532: The brain is involved. Muscle jerks may start in a specific muscle group and spread to surrounding muscle groups in which case it is known as a Jacksonian march . Automatisms may occur, which are non-consciously generated activities and mostly simple repetitive movements like smacking the lips or more complex activities such as attempts to pick up something. There are six main types of generalized seizures: They all involve loss of consciousness and typically happen without warning. Tonic-clonic seizures occur with

5454-403: The brain while generalized seizures begin in both hemispheres . Some types of seizures may change brain structure, while others appear to have little effect. Gliosis , neuronal loss, and atrophy of specific areas of the brain are linked to epilepsy but it is unclear if epilepsy causes these changes or if these changes result in epilepsy. The seizures can be described on different scales, from

5555-416: The brain, or birth defects through a process known as epileptogenesis . Known genetic mutations are directly linked to a small proportion of cases. The diagnosis involves ruling out other conditions that might cause similar symptoms , such as fainting , and determining if another cause of seizures is present, such as alcohol withdrawal or electrolyte problems. This may be partly done by imaging

5656-435: The brain, skin, heart, eyes and kidneys. In addition, abnormal mTOR activity is believed to alter neural excitability. The prevalence of epilepsy is estimated to be 80-90%. The majority of cases of epilepsy present within the first 3 years of life and are medically refractory. Relatively recent developments for the treatment of epilepsy in people with TSC include mTOR inhibitors , cannabidiol and vigabatrin. Epilepsy surgery

5757-459: The brain. These episodes can result in physical injuries, either directly, such as broken bones, or through causing accidents. In epilepsy, seizures tend to recur and may have no detectable underlying cause. Isolated seizures that are provoked by a specific cause such as poisoning are not deemed to represent epilepsy. People with epilepsy may be treated differently in various areas of the world and experience varying degrees of social stigma due to

5858-471: The business for $ 1 billion. Under Papa's leadership, by early 2018, the company had become profitable again; had settled the Allergan case for less than expected; and had lowered its debt by $ 6.5 billion. The company had divested itself of 13 non-core businesses, reducing its debt to $ 25 billion, and had settled or dismissed 70 pending lawsuits, including the Allergan insider trading case. On January 8, 2018,

5959-426: The case in 2017. On April 1, 2015, Valeant completed the purchase of gastrointestinal treatment drug developer Salix Pharmaceuticals for $ 14.5 billion after outbidding Endo Pharmaceuticals . On the final day of trading, Salix shares traded for $ 172.81, giving a market capitalisation of $ 10.9 billion. After the acquisition, Valeant raised the price of the diabetes pill Glumetza drastically. In July 2015,

6060-414: The cellular level to the whole brain. These are several concomitant factor, which on different scale can "drive" the brain to pathological states and trigger a seizure. The diagnosis of epilepsy is typically made based on observation of the seizure onset and the underlying cause. An electroencephalogram (EEG) to look for abnormal patterns of brain waves and neuroimaging ( CT scan or MRI ) to look at

6161-532: The commercial rights to some of Valeant's products for $ 1.4 billion. In July 2014, Valeant acquired PreCision Dermatology Inc for $ 475 million. Along with hedge fund manager Bill Ackman , Valeant made a bid to acquire Allergan ; however, in November 2014, Allergan announced that it would be acquired by Actavis in a $ 66 billion transaction. Valeant and Pershing Square were subsequently accused of insider trading prior to their Allergan bid, and eventually settled

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6262-472: The company announced it would acquire Mercury (Cayman) Holdings, the holding company of Amoun Pharmaceutical, one of Egypt's largest drugmakers, for $ 800 million. In August 2015, Valeant said it would purchase Sprout Pharmaceuticals Inc for $ 1 billion, a day after Sprout received approval to market the women's libido drug Addyi . In September 2015, Valeant licensed psoriasis drug Brodalumab from AstraZeneca for up to $ 445 million. In September 2015,

6363-670: The company announced its intention to acquire eye surgery product manufacturer Synergetics USA, for $ 192 million in order to strengthen the company's Bausch & Lomb division. In October 2015, the company's Bausch & Lomb division acquired Doctor's Allergy Formula for an undisclosed sum. On October 21, 2015, Citron Research founder Andrew Left , a short seller of Valeant shares, published claims that Valeant recorded false sales of products to specialty pharmacy Philidor Rx Services and its affiliates. These specialty companies were controlled by Valeant, and allegedly resulted in improper bookkeeping of revenues. In addition, by controlling

6464-685: The company announced that its Bausch + Lomb unit had received a CE Mark indicating conformity with health, safety, and environmental protection standards from the European Commission for the distribution of its Stellaris product in Europe. On December 16, 2019, the company settled a shareholder class action lawsuit under Section 11 of the U.S. Securities Act of 1933 , alleging the company misled investors about its business operations and financial performance, for approximately $ 1.21 billion. The company denied allegations of all wrongdoing as part of

6565-532: The company for 43 years, during which ICN established a foothold in the industry by acquiring niche pharmaceuticals and through the development of Ribavirin , an antiviral drug that became the standard treatment for hepatitis C . In 1994, ICN merged with SPI Pharmaceuticals Inc., Viratek Inc., and ICN Biomedicals Inc. On June 12, 2002, following a series of controversies, Panić was forced to retire under pressure from shareholders. In 2003, not long after Panić's ouster, ICN changed its name to Valeant. In 2006,

6666-693: The company received approval in the U.S. to market Cesamet (nabilone), a synthetic cannabinoid . The company also acquired the European rights to the drug for $ 14 million. In 2008, the Swedish pharmaceutical company Meda AB bought Western and Eastern Europe branches from Valeant for $ 392 million. In September 2008, Valeant acquired Coria Laboratories for $ 95 million. In November 2008, Valeant acquired DermaTech for $ 12.6 million. In January 2009, Valeant acquired Dow Pharmaceutical Sciences for $ 285 million. In July 2009, Valeant announced its acquisition of Tecnofarma,

6767-496: The company used to increase prescriptions for its own (expensive) drugs instead of generic substitutes. An important part of the growth strategy for Valeant under Michael Pearson had been the acquisition of medical and pharmaceutical companies and the subsequent price increases for their products. Valeant's strategy of exponential price increases on life-saving medicines was at the time described by Berkshire Hathaway vice chairman Charlie Munger as "deeply immoral" and "similar to

6868-609: The company's revenue totalled $ 8.76 billion (7.9% growth compared to 2022). Adjusted EBITDA totalled $ 3.01 billion (unchanged from 2022). Net debt was $ 21.65 billion, excluding $ 947 million on the balance sheet (5.7 times the company's market value). Three of Bausch Health's four operating segments increased revenue, with the highest result coming from Salix Pharmaceuticals (8% growth ), the company's largest business (nearly half of revenue, 59% of segment profit). About 80% of Salix's sales are Xifaxan , an antibiotic for treating diarrhea . Bausch Health Companies ( Salix Pharmaceuticals )

6969-480: The condition, and especially among children with epilepsy . The stigma of epilepsy can also affect the families of those with the disorder. Certain disorders occur more often in people with epilepsy, depending partly on the epilepsy syndrome present. These include depression , anxiety , obsessive–compulsive disorder (OCD), and migraine . Attention deficit hyperactivity disorder (ADHD) affects three to five times more children with epilepsy than children without

7070-442: The condition. The risk of epilepsy following meningitis is less than 10%; it more commonly causes seizures during the infection itself. In herpes simplex encephalitis the risk of a seizure is around 50% with a high risk of epilepsy following (up to 25%). A form of an infection with the pork tapeworm ( cysticercosis ), in the brain, is known as neurocysticercosis , and is the cause of up to half of epilepsy cases in areas of

7171-513: The condition. ADHD and epilepsy have significant consequences on a child's behavioral, learning, and social development. Epilepsy is also more common in children with autism . Approximately, one-in-three people with epilepsy have a lifetime history of a psychiatric disorder. There are believed to be multiple causes for this including pathophysiological changes related to the epilepsy itself as well as adverse experiences related to living with epilepsy (e.g., stigma, discrimination). In addition, it

7272-585: The court's original ruling, which blocks the FDA from approving Norwich Pharmaceuticals ' 550 mg rifaximin generic until October 2029. Judge Andrews' decision bolsters his previous ruling that Norwich's abbreviated new drug application for rifaximin infringed on Bausch Health's Xifaxan patents for the reduction in risk of hepatic encephalopathy recurrence. In June 2023, the company's oral health business OraPharma partnered with Alex Rodriguez to launch its "Cover Your Bases" gum disease awareness campaign. In 2023,

7373-491: The current classification of epilepsy. Categorization for these cases was made somewhat arbitrarily. The idiopathic (unknown cause) category of the 2011 classification includes syndromes in which the general clinical features and/or age specificity strongly point to a presumed genetic cause. Some childhood epilepsy syndromes are included in the unknown cause category in which the cause is presumed genetic, for instance benign rolandic epilepsy. Clinical syndromes in which epilepsy

7474-434: The degree of seriousness that epilepsy deserves. The definition is practical in nature and is designed for clinical use. In particular, it aims to clarify when an "enduring predisposition" according to the 2005 conceptual definition is present. Researchers, statistically minded epidemiologists, and other specialized groups may choose to use the older definition or a definition of their own devising. The ILAE considers doing so

7575-460: The drug. Lilly's Seconal came in a bright orange/red bullet shaped capsule known as a Pulvule. Prescription use of secobarbital decreased beginning in the early 1980s by which time benzodiazepines had become increasingly common. Secobarbital has acquired many nicknames, the most common being "reds," "red devils," or "red dillies" (because of the color of the capsules). Other common nicknames are "seccies," "Cardinals," "ruby slippers," and, according to

7676-400: The head, the risk is about 50%. Some evidence links epilepsy and celiac disease and non-celiac gluten sensitivity , while other evidence does not. There appears to be a specific syndrome that includes coeliac disease, epilepsy, and calcifications in the brain. A 2012 review estimates that between 1% and 6% of people with epilepsy have coeliac disease while 1% of the general population has

7777-513: The last 10 years, with no seizure medicines for the last 5 years. This 2014 definition of the International League Against Epilepsy (ILAE) is a clarification of the ILAE 2005 conceptual definition, according to which epilepsy is "a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures and by the neurobiologic, cognitive, psychological, and social consequences of this condition. The definition of epilepsy requires

7878-622: The limbs in unison. After the shaking has stopped it may take 10–30 minutes for the person to return to normal; this period is called the " postictal state " or "postictal phase." Loss of bowel or bladder control may occur during a seizure. People experiencing a seizure may bite their tongue, either the tip or on the sides; in tonic-clonic seizure , bites to the sides are more common. Tongue bites are also relatively common in psychogenic non-epileptic seizures . Psychogenic non-epileptic seizures are seizure like behavior without an associated synchronised electrical discharge on EEG and are considered

7979-413: The marketer and trade-name holder. At the time Marathon Pharmaceuticals obtained ownership of the brand name, the retail price for one 100 mg capsule (depending upon prescription size and pharmacy) averaged about one U.S. dollar. During the time Marathon owned the brand name, the company greatly increased the price of the drug. By February 2015, when Marathon sold the rights to Valeant Pharmaceuticals ,

8080-501: The name of the company was changed to Bausch Health Companies Inc., in order to distance itself from the public outrage associated with massive price increases introduced by Valeant. At the same time, a new ticker symbol , BHC replaced VRX . In 1959, Yugoslavian immigrant Milan Panić , who had defected to the US three years earlier, founded ICN Pharmaceuticals (International Chemical and Nuclear Corporation) in his Pasadena garage. Panić ran

8181-457: The occurrence of at least one epileptic seizure." It is, therefore, possible to outgrow epilepsy or to undergo treatment that causes epilepsy to be resolved, but with no guarantee that it will not return. In the definition, epilepsy is now called a disease, rather than a disorder. This was a decision of the executive committee of the ILAE, taken because the word disorder , while perhaps having less stigma than does disease , also does not express

8282-646: The pharmacy services offered by Philidor, Valeant allegedly steered Philidor's customers to expensive drugs sold by Valeant. One alleged practice entailed Valeant employees directly managing Philidor's business operations while posing as Philidor employees, and with all written communication under fictitious names. Valeant responded that the allegations by Citron Research were "erroneous". On October 30, 2015, Valeant said that it would cut ties with Philidor in response to allegations of aggressive billing practices. Walgreens Boots Alliance Inc, owner of Walgreens , took over distribution for Valeant. In 2018, Gary Tanner, who

8383-420: The point that treatment is no longer needed. As of 2021 , about 51 million people have epilepsy. Nearly 80% of cases occur in the developing world . In 2021, it resulted in 140,000 deaths, an increase from 125,000 in 1990. Epilepsy is more common in children and older people. In the developed world , onset of new cases occurs most frequently in babies and the elderly. In the developing world, onset

8484-423: The prevalence may range from 5% to 50% of people with epilepsy. People with refractory epilepsy who have a high seizure frequency are at the greatest risk for having seizure clusters. Seizure clusters are associated with increased healthcare use, worse quality of life, impaired psychosocial functioning, and possibly increased mortality. Benzodiazepines are used as an acute treatment for seizure clusters. After

8585-620: The production of rigid gas permeable contact lenses. Valeant's acquisition of Bausch & Lomb in 2013, and Paragon Vision Services in 2015, is alleged to have given the company control of over 80% of the production pipeline for hard contact lenses. A series of unilateral price increases beginning in Fall 2015 spurred the FTC's investigation. On November 15, 2016, Valeant agreed to divest itself of Paragon Holdings and Pelican Products to settle charges that its May 2015 acquisition of Paragon reduced competition for

8686-418: The products Retin-A Micro, Ertaczo , and Renova, also known as tretinoin . In August 2011, Valeant acquired 87.2% of the outstanding shares of Sanitas Group for €314 million. In December 2011, Valeant acquired iNova Pharmaceuticals for A$ 625 million from Australian private equity firms Archer Capital with additional milestone payments of up to A$ 75 million. In December 2011, Valeant acquired Dermik,

8787-436: The risk of epilepsy. Malnutrition is a risk factor seen mostly in the developing world, although it is unclear however if it is a direct cause or an association. People with cerebral palsy have an increased risk of epilepsy, with half of people with spastic quadriplegia and spastic hemiplegia having the condition. Normally brain electrical activity is non-synchronous, as large numbers of neurons do not normally fire at

8888-648: The sale of FDA-approved "buttons", the polymer discs used to make gas permeable contact lenses. In their 2015 annual report filed on April 29, 2016, Valeant said that it was the "subject of investigations" by the Securities and Exchange Commission, the U.S. Attorney's Offices in Massachusetts and New York, the state of Texas, the North Carolina Department of Justice , the Senate's Special Committee on Aging, and

8989-498: The same time, but rather fire in order as signals travel throughout the brain. Neuron activity is regulated by various factors both within the cell and the cellular environment. Factors within the neuron include the type, number and distribution of ion channels, changes to receptors and changes of gene expression . Factors around the neuron include ion concentrations, synaptic plasticity and regulation of transmitter breakdown by glial cells . The exact mechanism of epilepsy

9090-429: The settlement. On July 31, 2020, the SEC announced that Bausch Health had agreed to pay a $ 45 million penalty to settle charges of improper revenue recognition and misleading disclosures in SEC filings and earnings presentations. It also announced that Pearson would pay $ 250,000 in civil penalties to the SEC, as well as $ 450,000 to reimburse Valeant. Howard Schiller and Tanya Carro, two other executives who settled, paid

9191-497: The sole supplier of Seconal. Bausch Health stopped manufacturing the product in January 2022. The sodium salt of secobarbital is classified separately from the free acid, as follows: Epilepsy Epilepsy is a group of non-communicable neurological disorders characterized by recurrent epileptic seizures . An epileptic seizure is the clinical manifestation of an abnormal, excessive, and synchronized electrical discharge in

9292-598: The start, affecting both hemispheres of the brain and impairing consciousness . Two-thirds begin as focal seizures (which affect one hemisphere of the brain) which may progress to generalized seizures. The remaining 40% of seizures are non-convulsive. An example of this type is the absence seizure , which presents as a decreased level of consciousness and usually lasts about 10 seconds. Certain experiences, known as auras often precede focal seizures. The seizures can include sensory (visual, hearing, or smell), psychic, autonomic, and motor phenomena depending on which part of

9393-504: The structure of the brain are also usually part of the initial investigations. While figuring out a specific epileptic syndrome is often attempted, it is not always possible. Video and EEG monitoring may be useful in difficult cases. Epilepsy is a disorder of the brain defined by any of the following conditions: Furthermore, epilepsy is considered to be resolved for individuals who had an age-dependent epilepsy syndrome but are now past that age or those who have remained seizure-free for

9494-427: The world where the parasite is common. Epilepsy may also occur after other brain infections such as cerebral malaria , toxoplasmosis , and toxocariasis . Chronic alcohol use increases the risk of epilepsy: those who drink six units of alcohol per day have a 2.5-fold increase in risk. Other risks include Alzheimer's disease , multiple sclerosis , and autoimmune encephalitis . Getting vaccinated does not increase

9595-558: The worst abuses in for-profit education." This strategy had also attracted the attention of regulators in the United States, particularly after the publication in The New York Times of an article on price gouging of specialty drugs. In September 2015, an influential group of politicians criticized Valeant on its pricing strategies. The company raised prices on all its brand name drugs 66% in 2015, five times more than its closest industry peer. The cost of Valeant flucytosine

9696-614: Was 10,000% higher in the United States than in Europe. In late September 2015, members of the United States House Committee on Oversight and Government Reform urged the Committee to subpoena Valeant for their documents regarding the sharp increases in the price of "two heart medications it had just bought the rights to sell: Nitropress and Isuprel . Valeant had raised the price of Nitropress by 212% and Isuprel by 525%". By October 2015, Valeant had received subpoenas from

9797-489: Was a former Valeant executive, and Andrew Davenport, the former chief executive of Philidor Rx Services, were prosecuted over a kickback scheme. They were sentenced to a year in prison after being convicted on four charges, including wire fraud and conspiracy to commit money laundering. They were also ordered to forfeit $ 9.7 million in kickbacks. Tanner had been responsible for managing Valeant's relationship with Philidor as well as Valeant's "alternative fulfillment" program, which

9898-655: Was banned from senior roles at public companies in Canada for five years and penalized to pay $ 565,000 by the Ontario Securities Commission . In the year before the merger with Valeant, Melnyk had settled by the United States Securities and Exchange Commission (SEC), and agreed to pay a civil penalty of $ 150,000 after having previously paid $ 1 million to settle other claims with the SEC. In July 2011, Valeant acquired Ortho Dermatologics from Janssen Pharmaceuticals for $ 345 million. The acquisition included

9999-457: Was later featured in episode 3 of the first season of the Netflix documentary Dirty Money . In 2017, Ackman's Pershing Square fund, which held a major stake in the company, sold out for a reported loss of $ 2.8 billion. On April 25, 2016, Valeant named Perrigo chief executive Joseph Papa as a permanent replacement for Pearson, and entrusted him with turning around the company. Papa set on

10100-528: Was made available for physician-assisted suicide in Canada. Animal It is a component in the veterinary drug Somulose , used for euthanasia of horses and cattle . The LD 50 of secobarbital has been reported to be between 125 mg/kg (rat, oral) and 267 mg/kg (mouse, oral). Possible side effects of secobarbital include: Secobarbital may produce psychological addiction and produces physical dependence if used for an extended period of time. Withdrawal symptoms may occur if long-term use

10201-792: Was used to induce Fred Hampton into docility before he was then killed in his bed in the early hours of December 4, 1969. In 1978, 1,000 pills of Seconal were recovered in Jonestown , along with substantial quantities of Valium , Thorazine , Talwin , Demerol , and other sedatives , hypnotics , and analgesics . Human Secobarbital is used in assisted dying . In the Netherlands , individuals have two options for assisted dying : they can orally consume 100 mL of concentrated syrup containing either 15 grams of pentobarbital or 15 grams of secobarbital, or they can choose to have 2 grams of thiopental or 1 gram of propofol administered intravenously by

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