Anticonvulsants (antiepileptic or AEDs) help to normalize the way nerve impulses travel along the nerve cells which helps prevent or treat seizures. When the brain is functioning normally the nerve cells talk to each other using controlled electrical signals from one nerve cell to another. This tells the body to do everything it needs or wants to do. During a seizure there is a change in the level of nerve cell electrical signals from a normal level to excessive signals from a normal level to an excessive or abnormal amount of nerve signals. This increased nerve activity is responsible for the signs and symptoms of a seizure. What causes the change is nerve impulses can be the result of an injury to part of the brain, stroke, depression, brain tumor, genetic causes, metabolic problems or toxicity issues and others many such issues. Anticonvulsants can also be used for the treatment of nerve pain and bipolar disorder.
Anticonvulsants (also commonly known as antiepileptic drugs or as anti seizure drugs) are diverse groups of pharmacological agents used in the treatment of epileptic seizures. Anticonvulsants are also increasingly being used for the diagnosis of bipolar disorder and borderline personality disorder, since many seem to act as mood stabilizers, and for the treatment of neuropathic disorder. Anticonvulsants counter the excessive rapid firing of neurons during seizures. Anticonvulsants also prevent the seizure within the brain. Conventional antiepileptic drugs may block sodium channels or enhance gamma-aminobutyric acid (GABA) function. Many antiepileptic medicines have multiple or uncertain mechanisms of action. Next to the voltage-gated sodium channels and components of the GABA system, their targets include GABA receptors, the GAT-1, GABA transporter, and GABA transaminase. Additional targets include voltage-gated calcium channels, SV2A. By stopping sodium or calcium channels, antiepileptic medicines decreased the release of excitatory glutamate, whose relief is considered to be lessening in epilepsy, but also that of GABA. 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 proconulsively. Another potential target of antiepileptic drugs is the peroxisome proliferateor-activated receptor alpha. The drug class was the fifth-best-selling in the United States in 2008. Some anticonvulsants have shown sntiepileptogenic effects in animal models of epilepsy. That is, they either block the development of epilepsy or can curb or reverse the progression of epilepsy problems. 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).
How they work:-Anticonulsants keep the nerve cell impulses to normal level so they do not become excessive and uncontrolled, which is why they are used in seizure disorders and epilepsy. The way anticonvulsants manage the nerve impulses is not completely understood but is thought to be by their funcation on neurotransmitters like GABA, or acting on receptors like glutamate or by changing the electrical channels in the nerve cell of brain.
What they treat:-Anticonvulsants stabilize the level of nerve cell impulses and are used for a range of conditions including epilepsy, seizure disorders, nerve pain (neuropathic pain), bipolar disorder, etc.
Treatment guidelines:-Patients with newly diagnosed epilepsy who require treatment can be initiated on standard anticonvulsants such as carbamazepine, phenytoin, valproic, acid/valproate semisodium, Phenobarbital, or on the newer anticonvulsants gabapentin, lamotrigine, oxcarbazepine or topiramate. The choice of anticonvulsants lay on individual patient characteristics. Both newer and older medicine are generally equally effective and reliable in new onset epilepsy. The newer medicine tends to have fewer side effects as compared to older medicine. For newly diagnosed partial or mixed seizures, there is evidence for using gabapentin, lamotrigine, oxcarbazepine or topiramate as monotherapy. Lamotrigine can be involved in the options for children with newly diagnosed absence seizures.
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