antikonvulsan

Anticonvulsants, also called antiseizure drugs, are medications used to prevent or reduce seizures in epilepsy and to treat other conditions such as certain types of neuropathic pain and mood disorders. They work by dampening neuronal excitability through different mechanisms, including stabilization of voltage-gated sodium and calcium channels, enhancement of GABAergic inhibition, or reduction of excitatory glutamate activity.

The primary indication is epilepsy, where anticonvulsants aim to control focal and generalized seizures. In addition, several agents serve as mood stabilizers in bipolar disorder (for example, valproate and lamotrigine). Others are used for neuropathic pain (such as gabapentin and pregabalin) and for migraine prevention (topiramate, valproate).

Common drug classes and examples include:

- Sodium channel blockers: carbamazepine, oxcarbazepine, phenytoin, lamotrigine; they reduce repetitive neuronal firing.

- GABAergic agents: phenobarbital, primidone, benzodiazepines; valproate enhances GABA transmission.

- Calcium channel–targeting drugs: ethosuximide (primarily for absence seizures); gabapentin and pregabalin (alpha-2-delta ligands) modulate calcium currents.

- Other agents: topiramate, levetiracetam, lacosamide, zonisamide, cenobamate; each has distinct or multiple mechanisms.

Administration and safety considerations: Dosing and pharmacokinetics vary; some drugs require regular blood level monitoring and laboratory tests. Many anticonvulsants have significant drug interactions with other medications, especially enzyme inducers or inhibitors. Common side effects include drowsiness, dizziness, cognitive slowing, and GI symptoms; some can cause rash, weight changes, or mood changes. Teratogenic risks are a concern with several agents, notably valproate.

Withdrawal should be gradual to reduce seizure risk. Pregnancy management requires careful planning and specialist guidance.