The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. The goal of an anticonvulsant is to suppress the rapid and excessive firing of neurons that start a seizure. Failing this, a good anticonvulsant would prevent the spread of the seizure within the brain and offer protection against possible excitotoxic effects that may result in brain damage. An excellent anticonvulsant would have few serious side-effects. However, no such drug exists. Pharmacology (in Greek: pharmacon (φάρμακον) meaning drug, and logos (λόγος) meaning science) is the study of how chemical substances interact with living systems. ... Epilepsy in animals and List of people believed to have epilepsy cover topics complementary to this article, which deals with epilepsy in the general human population. ... This article is about the medical term, epileptic seizure, as distinct from psychogenic non-epileptic seizure. ... Drawing by Santiago Ramón y Cajal of cells in the pigeon cerebellum. ... Excitotoxicity is the pathological process by which neurons are damaged and killed by the overactivation of excitatory neurotransmitter receptors such as the NMDA receptor and AMPA receptor (which belong to the glutamate receptor family). ... Brain damage or brain injury is the destruction or degeneration of brain cells. ... An adverse drug reaction (abbreviated ADR) is a term to describe the unwanted, negative consequences sometimes associated with the use of medications. ...

Many anticonvulsants block Sodium (Na⁺) channels, Calcium (Ca²⁺) channels, AMPA receptors or NMDA receptors. Some anticonvulsants inhibit the metabolism of GABA or increase its release. Sodium channels are integral membrane proteins that exist in a cells plasma membrane and regulate the flow of sodium (Na+) ions into it. ... This article needs to be cleaned up to conform to a higher standard of quality. ... The AMPA receptor (AMPAR) is a non-NMDA-type ionotropic transmembrane receptor for glutamate that mediates fast synaptic transmission in the central nervous system. ... The NMDA receptor (NMDAR) is an ionotropic receptor for glutamate (NMDA (N-methyl d-aspartate) is a name of its selective specific agonist). ... Chemical structure of GABA Gamma-aminobutyric acid (GABA) is a neurotransmitter in widely divergent species. ...

In the following list, the dates in parenthesis are the earliest approved use of the drug.

Aldehydes

Main article: Aldehydes An aldehyde is either a functional group consisting of a terminal carbonyl group or a compound containing a terminal carbonyl group. ...

• Paraldehyde (1882). One of the earliest anticonvulsants. Still used to treat status epilepticus, particularly where there are no resuscitation facilities.

Paraldehyde is the cyclic form of three acetaldehyde molecules (a trimer). ...

Aromatic allylic alcohols

• Stiripentol (2001 - limited availability). Indicated for the treatment of severe myoclonic epilepsy in infancy (SMEI).

Stiripentol (marketed as Diacomit by Laboratoires BIOCODEX) is an anticonvulsant drug used in the treatment of epilepsy. ... Myoclonic seizures are brief twitches or jerks of muscles or groups of muscles. ...

Barbiturates

Main article: Barbiturates Barbiturates are drugs that act as central nervous system (CNS) depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ...

Barbiturates are drugs that act as central nervous system (CNS) depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. The following are classified as anticonvulsants: Barbiturates are drugs that act as central nervous system (CNS) depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ... Oral medication A medication is a licenced drug taken to cure or reduce symptoms of an illness or medical condition. ... See also sedative. ... Sedation is a medical procedure involving administration of sedative drugs, generally to facilitate a medical procedure, such as endoscopy, vasectomy, or minor surgery with local anaesthesia. ... Cetacaine, a typical topical anesthetic Anesthesia or anaesthesia (see spelling differences), is the process of blocking the perception of pain and other sensations. ... A section of the Anatomical Therapeutic Chemical Classification System. ...

• Phenobarbital (1912). See also the related drug primidone.
• Methylphenobarbital (1935). Known as mephobarbital in the US. No longer marketed in the UK
• Metharbital (1952). No longer marketed in the UK or US.
• Barbexaclone (1982). Only available in some European countries.

Phenobarbital was the main anticonvulsant from 1912 till the development of phenytoin in 1938. Today, phenobarbital is rarely used to treat epilepsy in new patients since there are other effective drugs that are less sedating. Phenobarbital sodium injection can be used to stop acute convulsions or status epilepticus, but a benzodiazepine such as lorazepam, diazepam or midazolam is usually tried first. Other barbiturates only have an anticonvulsant effect at anaesthetic doses. Phenobarbital (also phenobarbitone) (Luminal®) is a weak acid with the chemical formula C12H12N2O3. ... Primidone, is an anticonvulsant of the pyrimidinedione class whose active metabolites, phenobarbital (minor) and phenylethylmalonamide (PEMA) (major), are also anticonvulsants. ... Methylphenobarbital (also known as mephobarbital) is marketed in the US as Mebaral by Ovation. ... Metharbital was marketed as Gemonil by Abbott Laboratories. ... Barbexaclone (marketed in Italy as Maliasin by Abbott Laboratories). ...

Benzodiazepines

Main article: Benzodiazepines alprazolam 2mg tablets The benzodiazepines are a class of drugs with sedative, hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant properties. ...

The benzodiazepines are a class of drugs with hypnotic, anxiolytic, anticonvulsive, amnestic and muscle relaxant properties. The relative strength of each of these properties in any given benzodiazepine varies greatly and influences the indications for which it is prescribed. Long-term use can be problematic due to the development of tolerance and dependency. Of the many drugs in this class, only a few are used to treat epilepsy: Oral medication A medication is a licenced drug taken to cure or reduce symptoms of an illness or medical condition. ... Hypnotic drugs are a class of drugs that induce sleep, used in the treatment of severe insomnia. ... An anxiolytic is any drug or therapy used in the treatment of anxiety. ... Amnesia (or amnaesia in Commonwealth English) is a condition in which memory is disturbed. ... In medicine, a muscle relaxant is a drug that causes skeletal muscle contraction to cease. ... Drug tolerance occurs when a subjects reaction to a drug (such as a painkiller or intoxicant) decreases so that larger doses are required to achieve the same effect. ... Addiction is chronic disorder proposed to be precipitated by a combination of genetic, biological/pharmacological and social factors. ...

• Clobazam (1979). Notably used on a short-term basis around menstruation in women with catamenial epilepsy.
• Clonazepam (1974).
• Clorazepate (1972).

The following benzodiazepines are used to treat status epilepticus: Clobazam is triazolobenzodiazepine, also known as a 1,5-benzodiazepine, meaning that its diazepine ring has its nitrogen atoms at the 1 and 5 positions instead of the usual 1 and 4. ... Clonazepam (marketed by Roche under the trade-name Klonopin® in the United States and Rivotril® in Europe, Brazil and Canada) is a drug which is a benzodiazepine derivative. ... Clorazepate (brand name: Tranxene®) is a member of the group of drugs called benzodiazepines. ...

• Diazepam (1963). Can be given rectally by trained care-givers.
• Midazolam (N/A). Increasingly being used as an alternative to diazepam. This water-soluble drug is squirted into the side of the mouth but not swallowed. It is rapidly absorbed by the buccal mucosa.
• Lorazepam (1972). Given by injection in hospital.

Diazepam (pronounced , marketed under brand names Valium, Stesolid, Seduxen Bosaurin and Apozepam)[1] is a drug which is a benzodiazepine derivative. ... Midazolam, (marketed under brand names Versed®, Hypnovel® and Dormicum®) is a drug which is a benzodiazepine derivative. ... Buccal mucosa is mucous membrane of the inside of the cheek. ... Lorazepam (marketed under the brand names Ativan®, Temesta®, Tavor®) is a drug which is a benzodiazepine derivative. ...

Bromides

Main article: Bromides A bromide is a phrase, or person who uses phrases, which have been used and repeated so many times as to become either insincere in their meaning, or seem like an attempt at trying to explain the obvious. ...

• Potassium bromide (1857). The earliest effective treatment for epilepsy. There would not be a better drug for epilepsy until phenobarbital in 1912. It is still used as an anticonvulsant for dogs and cats.

Potassium bromide (KBr) is a salt, used as an anticonvulsant and a sedative in the 1800s. ...

Carbamates

Main article: Carbamates Carbamates are a group of organic compounds sharing a common functional group with the general structure -NH(CO)O-. More precisely the carbamate group is considered an amide group with an alkoxy or hydroxy functional group next to the carbonyl group. ...

• Felbamate (1993). This effective anticonvulsant has had its usage severely restricted due to rare but life-threatening side effects.

Felbamate (marketed as Felbamol by MedPointe) is an anticonvulsant drug used in the treatment of epilepsy. ...

Carboxamides

Main article: Carboxamides Carboxamides are drugs that can be used as anticonvulsants. ...

The following are carboxamides:

• Carbamazepine (1965). A popular anticonvulsant that is available in generic formulations.
• Oxcarbazepine (1990). A derivative of carbamazepine that has similar efficacy but is better tolerated.

Carbamazepine (sold under the brand-names Biston, Calepsin, Carbatrol, Epitol, Equetro, Finlepsin, Sirtal, Stazepine, Tegretol, Telesmin, Timonil) is an anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy and bipolar disorder. ... Oxcarbazepine (Marketed as Trileptal® by Novartis) is an anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy and bipolar disorder. ...

Fatty acids

Main article: Fatty acids In chemistry, especially biochemistry, a fatty acid is a carboxylic acid (or organic acid), often with a long aliphatic tail (long chains), either saturated or unsaturated. ...

The following are fatty-acids:

• The valproates — valproic acid, sodium valproate, and divalproex sodium (1978).
• Vigabatrin (1989).
• Progabide
• Tiagabine (1997).

Vigabatrin and progabide are also analogs of GABA. Valproic acid or 2-Propylpentanoic acid is CH3CH2CH2CH(CH2CH2CH3)COOH . ... Valproic acid or 2-Propylpentanoic acid is CH3CH2CH2CH(CH2CH2CH3)COOH . ... Sodium valproate (INN) or valproate sodium (USAN) is the sodium salt of valproic acid and is an anticonvulsant used in the treatment of epilepsy. ... Valproic acid or 2-Propylpentanoic acid is CH3CH2CH2CH(CH2CH2CH3)COOH . ... Vigabatrin is an anticonvulsant that inhibits the catabolism of GABA. It is an analog of GABA, but it is not a receptor agonist. ... Progabide (INN) is an analog of gamma-aminobutyric acid used in the treatment of epilepsy. ... Tiagabine is an anti-convulsive medication produced by Cephalon and marketed under the brand name Gabitril. ...

Fructose derivatives

Main article: Fructose Fructose (or levulose) is a simple sugar (monosaccharide) found in many foods and one of the three most important blood sugars along with glucose and galactose. ...

• Topiramate (1995).

Topiramate (brand name: Topamax®) is an anticonvulsant drug produced by Ortho-McNeil, a division of Johnson & Johnson. ...

Gaba analogs

• Gabapentin (1993).
• Pregabalin (2004).

Gabapentin (brand name: Neurontin®) was initially synthesized to mimic the structure of GABA for the treatment of epilepsy. ... Pregabalin (brand name: Lyrica®) is a new anticonvulsant drug indicated as an add on therapy for partial onset seizures and for certain types of neuropathic pain. ...

Hydantoins

Main article: Hydantoins Hydantoin, which is also known as glycolylurea, is a heterocyclic organic compound which can be thought of as a cyclic double-condensation reaction product of glycolic acid and urea. ...

The following are hydantoins:

• Ethotoin (1957).
• Phenytoin (1938).
• Mephenytoin
• Fosphenytoin (1996).

Ethotoin (marketed as Peganone® by Ovation) is an anticonvulsant drug used in the treatment of epilepsy. ... Phenytoin sodium (marketed as Dilantin® in the USA and as Epanutin® in the UK, by Parke-Davis, now part of Pfizer) is a commonly used antiepileptic. ... Mephenytoin (marketed as Mesantoin® by Novartis) is a hydantoin, used as an anticonvulsant. ... Fosphenytoin (Cerebyx®, Parke-Davis) is a water-soluble phenytoin prodrug used in only in hospitals for the treatment of epileptic seizures. ...

Oxazolidinediones

Main article: Oxazolidinediones The following are oxazolidinediones: paramethadione trimethadione ethadione Categories: Pharmacology stubs | Antiepileptics ...

The following are oxazolidinediones:

• Paramethadione
• Trimethadione (1946).
• Ethadione

Trimethadione is an oxazolidinedione anticonvulsant. ...

Propionates

Main article: Propionates The propionate (also propanoate) ion is C2H5COO− (propionic acid minus one hydrogen ion). ...

• Beclamide

Beclamide (marketed as Chloracon, Hibicon, Posedrine, Nydrane, Seclar, and other names) is a propionate and was used as a sedative and as an anticonvulsant. ...

Pyrimidinediones

Main article: Pyrimidinediones The following are pyrimidinediones: cytidine fluorouracil idoxuridine primidone thymidine trifluridine uridine References Classe : PYRIMIDINEDIONE ...

• Primidone (1952).

Primidone, is an anticonvulsant of the pyrimidinedione class whose active metabolites, phenobarbital (minor) and phenylethylmalonamide (PEMA) (major), are also anticonvulsants. ...

Pyrrolidines

Main article: Pyrrolidines Flash point 3 °C R/S statement R: 11 20/21/22 35 S: 16 26 28 36/37 45 RTECS number UX9650000 Related compounds Related compounds pyrrole piperidine Except where noted otherwise, data are given for materials in their standard state (at 25 °C, 100 kPa) Infobox disclaimer and...

• Brivaracetam
• Levetiracetam (1999).
• Seletracetam

Levetiracetam (brand name: Keppra®) is an anticonvulsant medication used to treat epilepsy. ...

Succinimides

Main article: Succinimides Succinimides are drugs that can be used as anticonvulsants. ...

The following are succinimides:

• Ethosuximide (1955).
• Phensuximide
• Mesuximide

Ethosuximide is a succinimide anticonvulsant, used mainly in absence seizures. ...

Sulfonamides

Main article: Sulfonamides In chemistry, the sulfonamide functional group is -S(=O)2-NH2, a sulfone group connected to an amine group. ...

• Acetazolamide (1953).
• Sulthiame
• Methazolamide
• Zonisamide (1990).

Acetazolamide, sold under the trade name Diamox®, is a carbonic anhydrase inhibitor that is used to treat glaucoma, epileptic seizures, benign intracranial hypertension and altitude sickness. ... Zonisamide (brand name Zonegran®) is an anticonvulsant used as an adjunctive therapy in adults with partial-onset seizures. ...

Triazines

Main article: Triazines ...

• Lamotrigine (1991).

Lamotrigine (marketed as Lamictal by GlaxoSmithKline) is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. ...

Ureas

Main article: Ureas Urea is an organic compound of carbon, nitrogen, oxygen and hydrogen, with the formula CON2H4 or (NH2)2CO. Urea is also known as carbamide, especially in the recommended International Non-proprietary Names (rINN) in use in Europe. ...

• Pheneturide
• Phenacemide

Valproylamides (amide derivatives of valproate)

Main article: Amides Amide functional group In chemistry, an amide is one of two kinds of compound. ...

• Valpromide
• Valnoctamide

Valpromide (dipropylacetamide, α-propylvaleramide, Diprozin) is a carboxamide derivative of valproic acid that is considered safer to use than either valproic acid or sodium valproate. ... Valnoctamide has been used in France as a tranquilizer and muscle relaxant since 1964[3] and as an anticonvulsant since starting in 1969 in Portugal. ...

See also

• ATC code N03

A section of the Anatomical Therapeutic Chemical Classification System. ...

References

• Drug Reference for FDA Approved Epilepsy Drugs
• UK Anti-Epileptic Drugs List

External links

• NINDS: Anticonvulsant Screening Program