Anticonvulsant

Anticonvulsants (also known as antiepileptic drugs, antiseizure drugs, or anti-seizure medications (ASM)) are a diverse group of pharmacological agents used in the treatment of epileptic seizures.^[1] Anticonvulsants are also increasingly being used in the treatment of bipolar disorder^[2][3] and borderline personality disorder,^[4] since many seem to act as mood stabilizers, and for the treatment of neuropathic pain.^[5] Anticonvulsants suppress the excessive rapid firing of neurons during seizures.^[6] Anticonvulsants also prevent the spread of the seizure within the brain.^[7]

Conventional antiepileptic drugs may block sodium channels or enhance γ-aminobutyric acid (GABA) function. Several antiepileptic drugs have multiple or uncertain mechanisms of action.^[8] Next to the voltage-gated sodium channels and components of the GABA system, their targets include GABA_A receptors, the GABA transporter type 1, 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] This is probably a side effect or even the actual mechanism of action for some antiepileptic drugs, since GABA can itself, directly or indirectly, act proconvulsively.^[12] Another potential target of antiepileptic drugs is the peroxisome proliferator-activated receptor alpha.^{[13][14][15][16][17][18][19]}

Some anticonvulsants have shown antiepileptogenic effects in animal models of epilepsy.^[20] That is, they either prevent the development of epilepsy or can halt or reverse the progression of epilepsy. However, no drug has been shown in human trials to prevent epileptogenesis (the development of epilepsy in an individual at risk, such as after a head injury).^[21]

Many anticonvulsants can cause birth defects in the unborn child if taken while pregnant.^[22]