Antiepileptic drugs (AEDs)

Antiepileptic drugs (AEDs), also known as antiseizure medications (ASMs), are used to manage epilepsy and other seizure disorders. They work by stabilizing electrical activity in the brain and preventing abnormal bursts of neuronal firing. Below is a classification of common antiepileptic drugs, their mechanisms, and key examples: --- 1. Sodium Channel Blockers Mechanism: Inhibit repetitive neuronal firing by blocking voltage-gated sodium channels. Drugs: Carbamazepine Phenytoin Lamotrigine Oxcarbazepine Lacosamide Used for: Focal (partial) seizures, tonic-clonic seizures. --- 2. Calcium Channel Blockers Mechanism: Reduce low-threshold (T-type) calcium currents in thalamic neurons. Drugs: Ethosuximide (for absence seizures) Valproate (also blocks sodium channels) --- 3. GABA Enhancers Mechanism: Boost GABA (inhibitory neurotransmitter) activity. Subtypes: GABA-A receptor agonists: Benzodiazepines (e.g., Diazepam, Lorazepam for acute seizures), Barbiturates (Phenobarbital). GABA reuptake inhibitors: Tiagabine. GABA transaminase inhibitors: Vigabatrin. Used for: Myoclonic seizures, tonic-clonic seizures, status epilepticus. --- 4. Glutamate Inhibitors Mechanism: Block excitatory NMDA or AMPA/kainate receptors. Drugs: Topiramate (also blocks sodium channels) Perampanel (AMPA receptor antagonist) --- 5. Synaptic Vesicle Protein Modulators Mechanism: Target SV2A protein to reduce neurotransmitter release. Drugs: Levetiracetam Brivaracetam --- 6. Broad-Spectrum AEDs (Effective for multiple seizure types) Valproate (Sodium valproate) Lamotrigine Levetiracetam Topiramate Zonisamide --- 7. Newer Generation AEDs Lacosamide (sodium channel modulator) Cenobamate (enhances GABA) Everolimus (for tuberous sclerosis-associated seizures) --- Key Considerations: 1. Choice of drug depends on seizure type (focal vs. generalized), patient age, comorbidities, and side effects. 2. Monitoring: Some AEDs require blood tests (e.g., Phenytoin, Carbamazepine). 3. Side Effects: Drowsiness (e.g., Benzodiazepines) Weight gain (e.g., Valproate) Teratogenicity (avoid Valproate in pregnancy). --- Commonly Treated Seizure Types: Focal seizures: Carbamazepine, Levetiracetam. Absence seizures: Ethosuximide, Valproate. Tonic-clonic seizures: Valproate, Lamotrigine. Myoclonic seizures: Levetiracetam, Valproate. Would you like details on a specific drug or treatment guidelines for a particular condition? 😊