Antiepileptic drug

Antiepileptic drugs (AEDs), also known as antiseizure drugs, are a diverse group of pharmacological agents used in the treatment of epilepsy.

History

The first antiepileptic drugs were the bromides, introduced by Sir Charles Locock in 1857. Phenobarbital was introduced in 1912, and phenytoin in 1938. The development of antiepileptic drugs accelerated during the last 50 years, with the introduction of carbamazepine and valproate in the 1960s, and many new AEDs in the 1990s and 2000s.

Mechanism of action

Antiepileptic drugs work by modifying the electrical activity of neurons in the brain. They do this by altering the balance of excitatory and inhibitory neurotransmission, or by directly affecting the electrical properties of neurons.

Types of antiepileptic drugs

There are several types of antiepileptic drugs, including:

• Sodium channel blockers: These drugs, such as carbamazepine and phenytoin, work by blocking the sodium channels in neurons, reducing their excitability.
• Calcium channel blockers: These drugs, such as ethosuximide, work by blocking the calcium channels in neurons, reducing their excitability.
• GABA enhancers: These drugs, such as benzodiazepines and barbiturates, work by enhancing the inhibitory effects of the neurotransmitter GABA.
• Glutamate blockers: These drugs, such as topiramate and lamotrigine, work by blocking the excitatory effects of the neurotransmitter glutamate.

Side effects

Like all drugs, antiepileptic drugs can have side effects. These can include dizziness, fatigue, weight gain, and more serious effects such as liver damage or suicidal thoughts.

Future developments

Research is ongoing into new antiepileptic drugs and new ways of delivering them. This includes the development of drugs that target specific types of epilepsy, and the use of gene therapy to modify the genetic causes of epilepsy.