The 7 types of anticonvulsant drugs (antiepileptic drugs)
Anticonvulsant medications, such as carbamazepine, lamotrigine, gabapentin or valproate, are prescribed especially in cases of epilepsy. Some of them have also proven effective in the management of 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 : the carboxamides, the structural analogs of GABA, the triazines, the fatty acid derivatives, the benzodiazepines, the barbiturates and the bromides. Some are used today, while others have lost relevance.
- Related article: "Psychotropic drugs: drugs that act on the brain"
What are anticonvulsants?
Anticonvulsant or antiepileptic drugs are a type of medication that is used primarily for treat seizures due to epileptic seizures or other causes . However, its 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 its Interaction with neurotransmitter receptors such as GABA and glutamate .
Other antiepileptic drugs block the sodium or calcium channels controlled by voltage; this reduces the function of the neurotransmitters associated with seizures. There are also several anticonvulsant drugs whose mechanism of action continues to be unknown at present, although its effectiveness has been demonstrated.
In the case of epilepsy, these effects reduce the frequency with which neurons trigger electrochemical signals, which prevents the neural dysfunctions that cause seizures from spreading through the brain, significantly limiting the severity of epileptic seizures .
Some anticonvulsants are used to stabilize the mood in different psychological disorders. In this sense, the popularization of its use in cases of bipolar disorder, which is characterized by the alternation of periods of depression and mania, and borderline personality disorder, in which there is instability of emotions and identity.
- Maybe you're interested: "Epilepsy: definition, causes, diagnosis and treatment"
Types of anticonvulsant drugs
Many different types of anticonvulsant drugs have been used since the use of potassium bromide to treat cases of "hysterical epilepsy" in the mid-nineteenth century. Currently, the use of these and other classic anticonvulsants, such as barbiturates and benzodiazepines, has been relegated to the background.
Nowadays the drugs of choice for the treatment of seizures They include carbamazepine and oxcarbazepine, which belong to the class of carboxamides, the structural analogs of GABA such as gabapentin and some other drugs, such as valproic acid and lamotrigine.
Carbamazepine and oxcarbazepine are two of the most commonly used anticonvulsants nowadays. In addition to treating epilepsy, carbamazepine is prescribed in cases of neuropathic pain, while oxcarbazepine is used as a coadjuvant medication in bipolar disorder when the symptoms do not remit with the drugs of choice.
These carboxamides are considered to be some of the safest treatments for seizures. Its side effects are usually slight or mild, limited to dizziness, nausea, vomiting, headaches or drowsiness; rarely cause more serious adverse reactions.
2. Structural analogues of GABA
The drugs that they act in a similar way 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 it plays in the brain"
3. Derivatives of fatty acids
The anticonvulsants derived from fatty acids, the most important of which is valproate or valproic acid, increase the availability of GABA in the nervous system or exert other agonist effects on it. As well block sodium and calcium channels controlled by voltage ; This results in an inhibition of brain activity.
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 result of Lennox-Gastaut syndrome.
Benzodiazepines, a type of sedative, have for many decades been the most used psychotropic drugs to treat problems related to physiological hyperactivation and cognitive , such as anxiety, muscle tension and insomnia. Among the benzodiazepines used as anticonvulsants are clonazepam and clobazam.
- Related article: "Benzodiazepines (psychodrugs): uses, effects and risks"
In 1912, phenobarbital, a drug of the barbiturate class, began to be used to prevent and treat the symptoms of epilepsy. Since then, many anticonvulsants have been found to have less intense and interfering sedative effects, although barbiturates are still occasionally used for their rapid effect in relieving seizures.
- Maybe you're interested: "Barbiturates: effects, mechanisms of action and toxicity"
Sodium bromide was the first drug to be used to treat epilepsy . Its origin goes back to the year 1857, when Charles Locock suggested this application. They were replaced by barbiturates after the emergence of phenobarbital in 1912, but bromides are still used as anticonvulsants in veterinary medicine, especially in dogs.