Which medications are used in the treatment of epileptic seizures?

Updated: May 30, 2019
  • Author: David Y Ko, MD; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Selection of an anticonvulsant medication depends on an accurate diagnosis of the epileptic syndrome. Although some anticonvulsants (eg, lamotrigine, topiramate, valproic acid, zonisamide) have multiple mechanisms of action, and some (eg, phenytoin, carbamazepine, ethosuximide) have only one known mechanism of action, anticonvulsant agents can be divided into large groups based on their mechanisms, as follows:

  • Blockers of repetitive activation of the sodium channel: Phenytoin, carbamazepine, oxcarbazepine, lamotrigine, topiramate

  • Enhancer of slow inactivation of the sodium channel: Lacosamide, rufinamide

  • Gamma aminobutyric acid (GABA)–A receptor enhancers: Phenobarbital, benzodiazepines, clobazam

  • NMDA receptor blockers: Felbamate

  • AMPA receptor blockers: Perampanel, topiramate

  • T-calcium channel blockers: Ethosuximide, valproate

  • N- and L-calcium channel blockers: Lamotrigine, topiramate, zonisamide, valproate

  • H-current modulators: Gabapentin, lamotrigine

  • Blockers of unique binding sites: Gabapentin, levetiracetam

  • Carbonic anhydrase inhibitors: Topiramate, zonisamide

  • Neuronal potassium channel (KCNQ [Kv7]) opener: Ezogabine


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