Which anticonvulsants 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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Some anticonvulsants (eg, lamotrigine, topiramate, valproic acid, zonisamide) have multiple mechanisms of action, and some (eg, phenytoin, carbamazepine, ethosuximide) have only 1 known mechanism of action. Anticonvulsants can be divided into large groups based on their mechanisms, as follows:

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

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

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

  • N -methyl-D-aspartic acid (NMDA) receptor blockers: Felbamate

  • Alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (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, perampanel

  • Carbonic anhydrase inhibitors: Topiramate, zonisamide

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

  • Other anticonvulsants: Cannabidiol, stiripentol

For more information, see Antiepileptic Drugs.

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