The 7 types of anticonvulsant (antiepileptic) drugs

Anti-seizure medications, such as carbamazepine, lamotrigine, gabapentin, or valproate, are mostly prescribed for epilepsy. Some of them have also been shown to be effective in managing the symptoms of other problems. psychological, such as bipolar disorder, anxiety, borderline personality disorder, or pain neuropathic.

In this article we will describe the features of the 7 main types of anticonvulsant or antiepileptic drugs: carboxamides, GABA structural analogs, triazines, fatty acid derivatives, benzodiazepines, barbiturates, and bromides. Some are used today, while others have lost their relevance.

• Related article: "Psychopharmaceuticals: drugs that act on the brain"

What are anticonvulsants?

Anticonvulsant or antiepileptic drugs are a type of medicine that is used mainly to treat seizures due to seizures or other causes. However, its uses are not limited exclusively to this symptom, but are increasingly being prescribed to stabilize mood and to reduce neuropathic pain.

Since there are many different anticonvulsants, it is not possible to describe a single mechanism of action. However, a significant proportion of these drugs reduce the electrochemical activity of the brain through their

interaction with neurotransmitter receptors such as GABA and glutamate.

Other antiepileptic drugs block voltage-gated calcium or sodium channels; This reduces the function of neurotransmitters associated with convulsive crisis. There are also various anticonvulsant drugs whose mechanism of action remains unknown at present, despite the fact that their effectiveness has been demonstrated.

In the case of epilepsy, these effects reduce the frequency with which neurons fire signals electrochemical, which prevents the neural dysfunctions that cause seizures from spreading through the brain, significantly limiting the severity of seizures.

Some anticonvulsants are used to stabilize mood in various psychological disorders. In this sense, the popularization of its use in cases of bipolar disorder stands out, which is characterized by the alternation of periods of depression and mania, and borderline personality disorder, in which there is instability of the emotions and of the identity.

• You may be interested: "Epilepsy: definition, causes, diagnosis and treatment"

Types of anticonvulsant drugs

Many different types of anticonvulsant drugs have been used since potassium bromide was first used to treat "hysterical epilepsy" in the mid-19th century. At present, the use of these and other classic anticonvulsants, such as barbiturates and benzodiazepines, has been relegated to the background.

Currently the drugs of choice for the treatment of seizures include carbamazepine and oxcarbazepine, which belong to the class of carboxamides, the analogs structural GABA such as gabapentin and some other medications such as valproic acid and lamotrigine.

1. Carboxamides

Carbamazepine and oxcarbazepine are two of the most widely used anticonvulsants currently. In addition to treating epilepsy, carbamazepine is prescribed for neuropathic pain, while oxcarbazepine is used as an adjunctive medicine in bipolar disorder when symptoms do not subside with drugs of choice.

These carboxamides are considered to be some of the safest treatments for seizures. Its side effects are usually few or mild, limited to dizziness, nausea, vomiting, headaches or drowsiness; they rarely cause more serious adverse reactions.

2. Structural analogues of GABA

The drugs that act similarly to the inhibitory neurotransmitter GABA they are called "structural analogs of GABA". The two most common anticonvulsants in this class are gabapentin, which is used to treat epilepsy, neuropathic pain and restless legs syndrome, and pregabalin, used in anxiety disorders and fibromyalgia.

• Related article: "GABA (neurotransmitter): what it is and what role does it play in the brain"

3. Fatty acid derivatives

The anticonvulsants derived from fatty acids, the most relevant of which is valproate or acid valproic, increase the availability of GABA in the nervous system or exert agonist effects of another type about this. Also block voltage-gated calcium and sodium channels; This results in an inhibition of brain activity.

4. Triazines

This class of antiepileptic drugs inhibits the release of excitatory neurotransmitters, mainly glutamate. Lamotrigine is part of this group and is used to treat bipolar disorder and different types of epileptic seizures: focal, tonic-clonic and those that appear as a consequence of the syndrome of Lennox-Gastaut.

5. Benzodiazepines

Benzodiazepines, a type of sedative, have been the most widely used psychotropic drugs for many decades to treat problems related to physiological hyperarousal and cognitivesuch as anxiety, muscle tension, and insomnia. Among the benzodiazepines used as anticonvulsants are clonazepam and clobazam.

• Related article: "Benzodiazepines (psychotropic): uses, effects and risks"

6. Barbiturates

In 1912, phenobarbital, a drug from the barbiturate class, began to be used to prevent and treat the symptoms of epilepsy. Since then, many anticonvulsants have been discovered that have less severe sedative and interfering agents, although barbiturates are still used on occasion due to their rapid effect in relieving crisis.

• You may be interested: "Barbiturates: effects, mechanisms of action and toxicity"

7. Bromides

Sodium bromide was the first drug to be used to treat epilepsy. Its origin dates back to 1857, when Charles Locock suggested this application. They were replaced by barbiturates after the emergence of phenobarbital in 1912, but today bromides are still used as anticonvulsants in veterinary medicine, especially in dogs.