The 7 Types Of Anticonvulsant Drugs (antiepileptics)
Anticonvulsant medications, such as carbamazepine, lamotrigine, gabapentin or valproate, are mainly prescribed in cases of epilepsy. Some of them have also been shown to be effective in managing the symptoms of other psychological problems, such as bipolar disorder, anxiety, borderline personality disorder or neuropathic pain.
In this article we will describe the characteristics of the 7 main types of anticonvulsant or antiepileptic drugs: carboxamides, structural analogues of GABA, triazines, fatty acid derivatives, benzodiazepines, barbiturates and bromides. Some are used today, while others have lost relevance.
Anticonvulsant or antiepileptic drugs are a type of medication that is mainly used to treat seizures due to epileptic seizures or other causes However, their uses are not limited exclusively to this symptom, but are increasingly prescribed to stabilize mood and 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 antiepileptics block voltage-gated sodium or calcium channels; This decreases the function of neurotransmitters associated with seizures. There are also various anticonvulsant drugs whose mechanism of action remains unknown today, despite the fact that their effectiveness has been demonstrated.
In the case of epilepsy, these effects reduce the frequency with which neurons fire electrochemical signals, which prevents the neural dysfunctions that cause seizures from spreading throughout the brain. significantly limiting the severity of epileptic 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, which is characterized by alternating periods of depression and mania, and borderline personality disorder, in which there is instability of emotions and identity, stands out.
Types of anticonvulsant drugs
Many different types of anticonvulsant drugs have been used since potassium bromide was first used to treat cases of “hysterical epilepsy” in the mid-19th century. Currently, the use of these and other classic anticonvulsants, such as barbiturates and benzodiazepines, has been relegated to the background.
Currently drugs of choice for the treatment of seizures They include carbamazepine and oxcarbazepine, which belong to the carboxamide class, structural analogues of GABA such as gabapentin, and some other medications such as valproic acid and lamotrigine.
1. Carboxamides
Carbamazepine and oxcarbazepine are two of the most used anticonvulsants currently. In addition to treating epilepsy, carbamazepine is prescribed in cases of neuropathic pain, while oxcarbazepine is used as an adjuvant medication in bipolar disorder when symptoms do not subside with the 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 They act similarly to the inhibitory neurotransmitter GABA They are called “structural analogues of GABA”. The two most common anticonvulsants in this class are gabapentin, used to treat epilepsy, neuropathic pain, and restless legs syndrome, and pregabalin, used in anxiety disorders and fibromyalgia.
Anticonvulsants derived from fatty acids, the most relevant of which is valproate or valproic acid, increase the availability of GABA in the nervous system or exert other types of agonist effects on it. Also block voltage-gated sodium and calcium channels ; This results in an inhibition of brain activity.
4. Triazines
This class of antiepileptic drugs inhibits the release of excitatory neurotransmitters, primarily glutamate. Lamotrigine is part of this group and is used to treat bipolar disorder and different types of epileptic seizures: focal seizures, tonic-clonic seizures, and those that appear as a consequence of Lennox-Gastaut syndrome.
5. Benzodiazepines
Benzodiazepines, a type of sedative, have been the most used psychotropic drugs for many decades to treat problems related to physiological hyperarousal and cognitive, such as anxiety, muscle tension and insomnia. Among the benzodiazepines used as anticonvulsants we find clonazepam and clobazam.
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 intense and interfering sedative effects, although barbiturates are still sometimes used for their rapid effect in relieving seizures.
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 currently bromides continue to be used as anticonvulsants in veterinary medicine, especially in dogs.
