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Anticonvulsants Overview

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Neil Tungbaban

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discuss the different anticonvulsants

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Anticonvulsants, also known as antiepileptic drugs (AEDs), are medications commonly used to manage
and prevent seizures in individuals with epilepsy. They work by stabilizing the electrical activity in the
brain to prevent abnormal and excessive firing of neurons that can lead to seizures. There are numerous
anticonvulsant medications available, each with its own mechanism of action, efficacy, and side effect
profile. Here are some of the commonly prescribed anticonvulsants:

Carbamazepine (Tegretol): This medication is effective against partial seizures and generalized tonic-
clonic seizures. It works by blocking voltage-gated sodium channels, preventing the excessive firing of
neurons. Common side effects include dizziness, drowsiness, nausea, and skin rashes. It may also have
interactions with other medications.

Valproic Acid (Depakote): Valproic acid is effective against many seizure types, including absence seizures
and tonic-clonic seizures. It increases the level of gamma-aminobutyric acid (GABA), a neurotransmitter
that inhibits neuronal activity. Side effects can include weight gain, hair loss, liver toxicity, and tremors. It
may also be associated with birth defects, so caution is advised during pregnancy.

Phenytoin (Dilantin): Phenytoin is commonly used to control partial and generalized tonic-clonic seizures.
It works by blocking voltage-gated sodium channels. Side effects can include gum overgrowth, dizziness,
coordination problems, and skin rashes. It may also have interactions with other medications.

Lamotrigine (Lamictal): Lamotrigine is effective against partial seizures and generalized tonic-clonic
seizures. Its mechanism of action involves reducing the release of glutamate, an excitatory
neurotransmitter. Rash is a common side effect, and in rare cases, it can be severe and life-threatening.
Lamotrigine requires a slow titration to minimize the risk of rash.
Levetiracetam (Keppra): Levetiracetam is used to treat partial seizures and generalized tonic-clonic
seizures. Its exact mechanism of action is not fully understood, but it is thought to modulate synaptic
vesicle protein binding. Common side effects include drowsiness, dizziness, and mood changes.

Topiramate (Topamax): Topiramate is effective against partial seizures and generalized tonic-clonic
seizures. It acts on multiple mechanisms, including enhancing GABA activity and blocking glutamate
receptors. Side effects may include cognitive difficulties, weight loss, and kidney stones.

Gabapentin (Neurontin) and Pregabalin (Lyrica): These medications are primarily used to treat partial
seizures and nerve pain associated with conditions like neuropathy and fibromyalgia. They work by
binding to calcium channels and reducing the release of neurotransmitters involved in pain signaling.
Common side effects include dizziness, drowsiness, and peripheral edema.

It's important to note that the choice of anticonvulsant depends on various factors, including the type of
seizures, the individual's response to the medication, potential side effects, and any underlying medical
conditions. Dosages and combinations of these medications may vary based on individual needs, and it's
crucial to consult with a healthcare professional for appropriate diagnosis and treatment.

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