User:Doc James/AHFS/M

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Doc James/AHFS/M
Drug class
Other namesAntiepileptic drugs (AEDs), antiseizure drugs[1]
Clinical data
UsesEpilepsy, bipolar, neuropathic pain[2]
Biological targetBrain[1]
External links
Drugs.comDrug Classes

Anticonvulsants, also known as antiepileptic or antiseizure drugs, are a class of medicines used in the treatment of epilepsy and other conditions that cause seizures.[1][3] Some may be used to treat bipolar disorder or neuropathic pain.[4] Which one is used depends on the type of epilepsy or type of seizure.[5] They are available to take by mouth, injection into vein, or insertion into rectum.[5] They may be taken one or more times a day.[5] Sometimes more than one anticonvulsant is required.[5]

Side effects vary between the different anticonvulsants.[6] Interactions with other medicines may lead to toxic levels of antivulsants.[5] Stopping them suddenly can be dangerous.[5] Use in pregnancy may harm the baby, but if needed then lamotrigine and levetiracetam may be options.[5]

Anticonvulsants act by affecting certain molecules in the brain.[1] They suppress the excessive rapid firing of neurons during seizures and may also prevent the spread of the seizure within the brain.[7][8] Conventional anticonvulsants may block sodium or calcium channels, or enhance GABA function.[4] Some anticonvulsants have multiple or uncertain mechanisms of action.[4] Next to the voltage-gated sodium channels and components of the GABA system, their targets include GABAA receptors, the GAT-1 GABA transporter, and GABA transaminase.[9] Additional targets include voltage-gated calcium channels, SV2A, and α2δ.[10][11] By blocking sodium or calcium channels, antiepileptic drugs reduce the release of excitatory glutamate, whose release is considered to be elevated in epilepsy, but also that of GABA.[12]

The first anticonvulsant was bromide, suggested in 1857 by the British gynecologist Charles Locock who used it to treat women with "hysterical epilepsy" (probably catamenial epilepsy).[13]

  1. 1.0 1.1 1.2 1.3 Rogawski, Michael A. (2020). "24. Antiseizure drugs". In Katzung, Bertram G.; Trevor, Anthony J. (eds.). Basic and Clinical Pharmacology (15th ed.). New York: McGraw-Hill. pp. 422–455. ISBN 978-1-260-45231-0.
  2. "List of Anticonvulsants (AEDs) - Generics Only". Retrieved 19 November 2021.
  3. Al-Otaibi, Faisal (2019-09-01). "An overview of structurally diversified anticonvulsant agents". Acta Pharmaceutica (Zagreb, Croatia). Walter de Gruyter GmbH. 69 (3): 321–344. doi:10.2478/acph-2019-0023. ISSN 1846-9558. PMID 31259739.
  4. 4.0 4.1 4.2 Ritter, James M.; Flower, Rod; Henderson, Graeme; Loke, Yoon Kong; Rang, Humphrey P. (2020). "46. Antiepileptic drugs". Rang & Dale's Pharmacology (9th ed.). Elsevier. pp. 580–591. ISBN 978-0-7020-7448-6.
  5. 5.0 5.1 5.2 5.3 5.4 5.5 5.6 "4. Nervous system". British National Formulary (BNF) (82 ed.). London: BMJ Group and the Pharmaceutical Press. September 2021 – March 2022. pp. 324–329. ISBN 978-0-85711-413-6.{{cite book}}: CS1 maint: date format (link)
  6. "Epilepsy Drugs to Treat Seizures". WebMD. Retrieved 16 November 2021.
  7. McLean, M J; Macdonald, R L (June 1986). "Sodium valproate, but not ethosuximide, produces use- and voltage-dependent limitation of high frequency repetitive firing of action potentials of mouse central neurons in cell culture". Journal of Pharmacology and Experimental Therapeutics. 237 (3): 1001–1011. PMID 3086538.
  8. Harden, C. L. (1 May 1994). "New antiepileptic drugs". Neurology. 44 (5): 787–95. doi:10.1212/WNL.44.5.787. PMID 8190276. S2CID 75925846.
  9. Rogawski MA, Löscher W (July 2004). "The neurobiology of antiepileptic drugs". Nature Reviews Neuroscience. 5 (7): 553–64. doi:10.1038/nrn1430. PMID 15208697. S2CID 2201038.
  10. Rogawski MA, Bazil CW (July 2008). "New molecular targets for antiepileptic drugs: alpha(2)delta, SV2A, and K(v)7/KCNQ/M potassium channels". Curr Neurol Neurosci Rep. 8 (4): 345–52. doi:10.1007/s11910-008-0053-7. PMC 2587091. PMID 18590620.
  11. Meldrum BS, Rogawski MA (January 2007). "Molecular targets for antiepileptic drug development". Neurotherapeutics. 4 (1): 18–61. doi:10.1016/j.nurt.2006.11.010. PMC 1852436. PMID 17199015.
  12. Kammerer, M.; Rassner, M. P.; Freiman, T. M.; Feuerstein, T. J. (2 May 2011). "Effects of antiepileptic drugs on GABA release from rat and human neocortical synaptosomes". Naunyn-Schmiedeberg's Archives of Pharmacology. 384 (1): 47–57. doi:10.1007/s00210-011-0636-8. PMID 21533993. S2CID 1388805.
  13. Rho, Jong M.; White, H. Steve (24 October 2018). "Brief history of anti‐seizure drug development". Epilepsia Open. 3 (Suppl Suppl 2): 114–119. doi:10.1002/epi4.12268. ISSN 2470-9239. PMID 30564769.