Anticonvulsant drugs. Anticonvulsant (antiepileptic) drugs

The date: 08.03.2020

Anticonvulsants for epilepsy are essential. Medicines prevent fatal outcome recurrence of epileptic seizures.

For the treatment of pathology, drugs of the group of tranquilizers, anticonvulsants are selected. The choice of drugs in children and adults is different. Read the details in the article.

Anticonvulsants for epilepsy: a list

List of common anticonvulsants for epilepsy:

Beclamid;
Carbamazepine;
Phenobarbital;
Primidon;
Clonazepam;
Phenytoin;
Valproate.

When using the described drugs, they stop different kinds epilepsy - temporal, focal, cryptogenic, idiopathic. When prescribing pills, you need to be careful about complications, since drugs often provide adverse reactions.

Medicines for minor seizures:

Trimethadone;
Ethosuximide.

The rationality of prescribing these tablets in children has been confirmed by clinical experiments, since they form a smaller number of adverse reactions.

Due to the high toxicity, scientists are constantly looking for new tools, since the use of common groups is limited by a number of reasons:

The need for long-term use;
Extensive spread of epileptic seizures;
The need to treat concomitant neurological and mental diseases;
An increase in the incidence of the disease in the elderly.

Most of the medical costs are for the treatment of cases of the disease with relapses. Such patients get used to drugs that are used for several years. The disease progresses against the background of taking pills, injections.

With resistance to therapy, a whole bunch of dangerous concomitant complications arise - depression, stroke, mental retardation.

The main task of the competent prescription of anticonvulsants for epilepsy is the choice of the optimal dose that allows controlling the disease, but leading to minimal side effects.

Bioavailability is individual for each person, the duration of therapy varies - these factors play a significant role in choosing the tactics of therapy. A gradual increase in the number of remissions saves additional funds by reducing the number of bed days. An increase in the frequency of outpatient doses allows you to optimally select the dosage of antiepileptic drugs.

Anticonvulsants for epilepsy - generic or natural

Treatment of epilepsy with drugs is long, so the price of the drug plays a significant role. Registration of generics requires the determination of bioavailability when compared with original drugs. Antiepileptic drugs are prescribed to reduce the number of relapses, reduce the severity of pathological seizures.

There are a number of European studies indicating the occurrence of epileptic seizures with the use of synthetic drugs that include the same substrate as when using natural analogue. The effect appears due to the different bioavailability of generics and natural analogues. The mechanism of metabolism, catabolism of many synthetic drugs is not well understood, so this choice is not always rational.

Signs of cirrhosis of the liver and portal hypertension

Treatment of epilepsy with anticonvulsants in children is carried out by a group of valproates, the availability of which reaches 100%. Clinical practice shows the effectiveness of using this group in a child with tonic-clonic, myoclonic seizures. In infants, valproate is used to treat generalized forms accompanied by secondary seizures.

List of antiepileptic valproates:

Depakine;
Convulex;
Apilepsin;
Ethosuximide;
Phenytoin;
cabamazepine;
Encorate;
Valparin XP.

When choosing the right drug, it is necessary to take into account all clinical symptoms to conduct a thorough diagnosis of the patient's condition.

Before treating epileptic seizures in children, certain principles must be observed:

food regimen;
Drug treatment with anticonvulsants;
Psychotherapeutic methods;
Neurosurgical operations.

When prescribing a drug for a child, toxicity should be assessed. To reduce the number of negative effects, you need to start therapy with a minimum dosage. A gradual increase in concentration is carried out until the seizures stop. If the remedy does not help, a gradual cancellation is required. The described concept of "monotherapy" is common throughout the world. European doctors are based on reducing the toxicity of drugs for children.

Researchers different countries of the world describe the errors of this scheme, but alternative methods are not indicated. Errors in the use of several drugs are also described in the literature. side effects much more occurs with polytherapy.

When prescribing several anticonvulsants in low doses, the toxicity of each agent is summed up separately. With this approach, the anticonvulsant activity of the agent is not achieved, but toxicity sharply increases.

Polytherapy with multiple drugs leads to an increase in seizures, since primary cause difficult to diagnose. It is impossible to ignore the intellectual problems that arise with an increase in the blood of tranquilizers, antidepressant drugs.

The true cause of the disease in most cases cannot be established, therefore, therapy cannot be directed solely to the focus of hyperexcitation. Removal of increased excitability of brain tissue chemical compounds leads to a short-term effect.

Studies have been conducted on the use of polytherapy in epilepsy. Experiments have revealed the best combination therapy for the disease:

Sequential dose changes throughout the week;
Mandatory control of laboratory parameters every 3 days;
If the cessation of seizures is achieved, the remedy that led to the restoration of the condition should be chosen. It should be prescribed at a dose that has stabilized the patient's condition;
Continuous monitoring of blood valproate levels. The concentration adequately reflects the body's response to therapeutic measures. Drug intoxication is often observed in children, so the level of toxins should be constantly monitored;
In the treatment of anticonvulsants, the development of hematological pathology, impaired liver function is possible. Biochemical analysis blood allows you to study the level of indicators of cholestasis. Enzymes AlAt, AsAt reflect the degree of damage to hepatocytes. US doctors talk about the need to control all biochemical parameters, since the treatment with anticonvulsants can lead to pathology of many internal organs;
Antiepileptic medicines canceled gradually. A sharp rejection of barbiturates is especially dangerous. In a group of patients, the abolition of these drugs causes the formation of status epilepticus - a series of loss of consciousness, muscle cramps.

The largest study of the genetic sequences of people with epilepsy

Obviously, drug therapy for epilepsy should be selected individually by a psychiatrist.

Epilepsy pills: list, prescription scheme

List of epilepsy pills:

Phenytoin;
Topiramate;
Vigabatrin;
Valproic acid;
Benzobarbital;
Acetazolamide;
Clonazepam;
midazolam;
Difenin;
Nitrazepam.

The most common epilepsy pills in Russian Federation are members of the valproic acid group.

List of drugs in this group:

Convulex;
Convulsofin;
Depakine-chrono;
Tegretol;
Finlepsin retard;
Pagluferal;
Luminal.

When using dormicum and seduxen (diazepam), a minimal number of side effects can be traced.

Treatment of epilepsy with folk remedies - patient reviews

To prevent seizures, reduce the number of relapses, folk remedies are recommended:

The use of raw onion juice leads to a decrease in the number of repeated convulsions, but only when properly combined with antiepileptic tablets;
Valerian officinalis, when used at night, calms the activity of the brain tissue, so the number of relapses decreases. The effectiveness of this drug is quite low, so it is recommended to use valerian only as an adjunct to therapy. For medicinal purposes at home, you can boil the roots in water for 15 minutes;
Motherwort tincture is used in 2 teaspoons of crushed raw materials after insisting on an alcohol solution;
Pour 2 tablespoons of raw materials for a duration of 2 hours. For the treatment of epilepsy, it is recommended to use 500 ml of tincture immediately after meals. Purpose - for the treatment of insomnia;
May lily of the valley is used as a decoction. For treatment, the appointment of 15 grams of flowers dissolved in 200 ml of boiled water is recommended. We recommend the use of a decoction of 2 teaspoons;
Soft bedstraw tincture is recommended for use in 2 tablespoons. Infuse should be 2 tablespoons of herbs per liter of boiled water. Treatment requires the use of half a glass 4 times a day;
Adonis (Spring Adonis) is taken simultaneously with codeine and bromine. For treatment, it is required to prepare the following composition - 6 grams of grass are poured with boiling water. After straining, 3 tablespoons are used;
White mistletoe is prepared by 15 grams of fruits and branches by dissolving in 200 ml of boiled water. For treatment, it is recommended to take a tablespoon three times a day;
Stone oil includes more than 70 useful substances. The tool has an immunomodulatory, antispasmodic effect. Siberian recipe involves dilution in 2 liters of water 3 grams of stone oil. Duration of therapy - 1 month;
Maryin root is used for paralysis, neurasthenia, epileptic convulsions. To prepare the medicine, you should insist 3 tablespoons of the plant in half a liter of alcohol for a week. Use three times a day for a teaspoon;
The smell of myrrh resin has a regenerative effect on the brain. For treatment, you need to place the resin in the room where the person stays. Duration of therapy - 1.5 months;
Skvortsov's drink is unique drug which has a patent. The drug is used to restore balance nervous system, improve conductivity, normalize memory, increase efficiency, improve vision and smell, restore the functioning of the cardiac system.

Diet features are big number fat, so the menu is not recommended for people with severe obesity. The ketogenic diet is not prescribed for renal or hepatic insufficiency, chronic diseases of parenchymal organs.

Diet therapy is not used for patients with atherosclerosis, diseases of the cardiovascular system.

The ketogenic diet plan:

A large number of fiber (cereal products, bran);
Take meals no later than 3 hours before bedtime;
fluid restriction;
Fats - no restrictions.

Sample ketogenic diet menu for adults:

Salad with cottage cheese and carrots;
Borscht with meatballs;
Big orange;
Fish fillet with lemon;
Kissel with breadcrumbs;
Vermicelli soup with meat;
Chicken roll with egg;
Fruit salad with yogurt;
Tea with crackers and milk;
Cabbage rolls;
Sandwich with cheese.

The ketogenic diet in children contains a similar menu, but is prescribed without special restrictions, since children do not develop atherosclerosis, acquired heart defects are quite rare.

The action of anticonvulsants

The action of anticonvulsants is aimed at eliminating muscle spasms and epileptic seizures. Some of these drugs are taken in combination to achieve best result. They not only relieve convulsions, but also facilitate the general condition of the body. The first attempts at such treatment were made at the end of the 9th and beginning of the 20th century. Then, potassium bromide was used to combat seizures. Since 1912 they began to use Phenobarbital. Since 1938, the list has been replenished with Phenytoin. Currently modern medicine uses more than thirty medicines. Today, more than 70% of people suffer mild form epilepsy and are successfully treated with anticonvulsants. However, treatment severe forms disease remains one of the most urgent problems for scientists. Any prescribed medicine must have anti-allergic properties in the absence of effects on the central nervous system. It is also necessary to exclude addiction, a feeling of apathy and weakness.

The main task of each remedy is to eliminate spasms without suppressing the central nervous system of psychophysical disorders. Any drug is prescribed only by a doctor after comprehensive survey and areas of the brain. Taking anticonvulsant drugs can last for several years, and in some cases throughout life. This happens in case of severe heredity or chronic form diseases. In some situations, in addition to drug therapy is being done surgery in the affected area of the brain.

Groups of anticonvulsants

Modern medicine classifies anticonvulsants according to the following scheme:

barbiturates;
hydantoin preparations;
oxazolidiones;
drugs based on succinamide;
iminostilbenes;
benzodiazepine tablets;
valproic acid products

Anticonvulsant drugs list

The main anticonvulsants are:

Phenytoin. It is used when seizures with status epilepticus. Its action is aimed at inhibiting nerve receptors and stabilizing membranes at the level of the cell body. The drug has a number of side effects: nausea, trembling, vomiting, involuntary rotation of the eyes, dizziness.
Carbamazeline is used for major convulsive psychomotor seizures. It stops severe attacks in the active stage of the disease. During the reception, the patient's mood improves. But there are a number of side effects: impaired blood circulation, drowsiness, dizziness. Contraindications are pregnancy and allergies.
Phenobarbital is used in epileptic seizures in conjunction with other drugs. The medicine calms and normalizes the nervous system. Pego should be taken long time. Cancellation occurs very carefully and gradually, as the elements of the drug accumulate in the body. Among the side effects of the disorder blood pressure, shortness of breath. Do not use during lactation and in the first trimester of pregnancy. It is also prohibited to use kidney failure, with muscle weakness and alcohol dependence.
Clonazepam is used for myoclonic epilepsy and psychomotor seizures. The drug eliminates involuntary convulsions and reduces their intensity. Under the influence of tablets, the muscles relax and the nervous system calms down. Among the side effects are a disorder of the musculoskeletal system, fatigue, irritability, prolonged depression. Contraindication to use is heavy physical work requiring increased concentration attention, pregnancy, kidney failure and liver disease. During treatment in without fail you should stop drinking alcohol.
The action of the drug Lamotrigine is aimed at eliminating severe seizures, mild seizures and clonic and tonic convulsions. It stabilizes the activity of brain neurons, which leads to a reduction in seizures and eventually they completely disappear. The side effect can be skin rash, nausea, dizziness, diarrhea, tremors. It is not recommended during the treatment period to engage in physical work that requires increased concentration.
Sodium volproate is indicated for the treatment of severe psychomotor seizures, mild seizures, and myoclonic epilepsy. The drug reduces the production of electrical impulses in the brain, eliminates anxiety and stabilizes mental condition sick. Side effects are expressed by disorders gastrointestinal tract, circulatory disorders and blood clotting. You can not take the medicine during pregnancy and lactation, with diseases of the pancreas, as well as hepatitis in various forms.
Primidone is used for psychomotor seizures and myoclonic epilepsy. The action of the drug inhibits the activity of neurons in the damaged area of the brain and eliminates involuntary spasms. Due to the fact that the drug causes increased arousal, it is not prescribed to children and the elderly. Side effects include: nausea, allergies, anemia, headaches, apathy and addiction. Contraindicated use during pregnancy and lactation, as well as liver disease and renal failure.
Beklamid stops generalized and partial seizures. He blocks electrical impulses in the head, reduces excitability and eliminates convulsions. Side effects include dizziness, gastrointestinal irritation, weakness, and allergies. Use is contraindicated in case of hypersensitivity to the components of the drug.
Benzobamil is prescribed for children with epilepsy, as well as for focal seizures. This is the least toxic drug that has a sedative effect on the central nervous system. Side effects include weakness, nausea, lethargy, and involuntary eye movements. Treatment with the drug is contraindicated in heart, kidney failure and liver disease.

Non-prescription anticonvulsants

Anticonvulsants are prescribed only by a doctor for the treatment serious illnesses Therefore, they can only be purchased with a prescription. Of course, you can try to buy them without a prescription, but this can seriously harm your health. If you order some medicines in an online pharmacy, then often you will not be asked for a prescription.

Anticonvulsants for the legs

If there is no epilepsy and inflammation of the nerves in the history of the disease, then the following drugs are prescribed for the treatment of convulsions:

Valparin suppresses convulsive activity in epileptic seizures. It does not have a pronounced sedative and hypnotic effect.
Xanax is a psychotropic drug that relieves feelings of anxiety, fear and emotional stress. It has a moderate sedative effect.
Difenin has a muscle relaxant and anticonvulsant effect. It increases the pain threshold for neuralgia and reduces the duration of convulsive attacks.
Antinerval relieves convulsions, depression and anxiety. It is also used to prevent depressive disorders.
Keppra is an anti-epileptic drug designed to suppress neuronal firing and relieve seizures.

In no case should you take these medicines on your own, since the cause of seizures can be hypothermia, trauma, flat feet, or a lack of certain vitamins.

Anticonvulsants for children

Anticonvulsant therapy for children provides an individual approach to each small patient. The frequency of attacks, at what time they occur, the overall clinical picture is taken into account. An important point in treatment is the correct selection of drugs and doses. Proper Treatment helps in many cases to completely get rid of seizures. At first, small doses of the drug are prescribed, which gradually increase. It is necessary to keep accurate records of seizures and monitor their dynamics. Seizures in infants and toddlers are always an indication for emergency medical measures. Delay can lead to swelling of the brain and damage to vital functions in the body. Initially, a 20% glucose solution is administered intravenously. If convulsions continue, then very carefully, controlling the work of the heart muscle, a 25% solution of magnesium sulfate is administered. If the effect does not occur, then pyridoxine hydrochloride is prescribed. The main drug is Phenobarbital. It calms the baby and has a dehydrating effect. The drug is prescribed according to age doses and depending on the nature and frequency of attacks. If after two or three days there is no improvement, then sodium bromide, Caffeine or Benzonal are added. In some cases, treatment is combined with the appointment of Difenin. It does not have cumulative properties, can give side effects in the form of decreased appetite, nausea, irritation on the oral mucosa, stomatitis. Children with frequent convulsions Hexamidin is sometimes prescribed in combination with Phenobarmital and Definin. In inhibited babies, such treatment significantly improves the condition. Contraindications are diseases of the kidneys, liver and blood-forming organs. AT early age often prescribed treatment with a mixture of Sereysky or its modifications. The main components of the drug are caffeine, papaverine, luminal.

Anticonvulsants are medicines that can prevent seizures of various severity and origin without affecting other body functions. This extensive pharmacological group also called anticonvulsants. It is divided into several subgroups of the second and third levels, as well as new and old generation drugs. Which of the drugs is suitable in each individual case, the attending physician must decide.

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Classification

Anticonvulsants are divided into several generally accepted classifications, each of which is actively used in medicine. The first classification subdivides anticonvulsants according to the mechanism of action, the second - according to chemical structure active substance.

Not a single anticonvulsant drug is dispensed in a pharmacy without a prescription.

According to the mechanism of action

Anticonvulsants work by two main mechanisms: stimulation of dopaminergic transmission and inhibition of cholinergic transmission. Means representing these groups are presented in the table:

Anticholinergics that do not have a central effect, but are effective locally, as a rule, are not used in the treatment of convulsions.

By chemical structure

The classification of drugs with anticonvulsant action by chemical structure is more extensive. It includes five main groups that combine drugs according to the structure of the active substance:

The table shows the main groups of anticonvulsants by chemical structure. Drugs based on valproic acid, iminostilbenes, oxazolidinones can also be used. In the treatment of convulsions and neuralgia, it is important not only to achieve therapeutic effect but also reduce the risk of side effects. For this, a classification of anticonvulsants has been developed for each type of epileptic seizure. The classification presents drugs of a new generation.

Drugs of choice

Drugs of choice are drugs that are widely used for certain diseases and in most of the cases studied exhibit the greatest efficiency.The main convulsive pathologies and a list of drugs of choice for them:

psychomotor and large convulsive seizures, status epilepticus - Difenin;
psychomotor and large convulsive seizures in stroke - Carbamazepine;
psychomotor seizures, myoclonic epilepsy - Clonazepam;
severe psychomotor partial seizures, clonic-tonic convulsions - Lamotrigine;
myoclonic epilepsy - sodium valproate;
focal seizures, status epilepticus in children - Benzobamil.

If the drugs of choice do not have an effect or are poorly tolerated, the option of replacing the drug with an analogue according to the action from the second line of drugs for a specific pathology is considered.

Difenin

Phenytoin is the first line of treatment for status epilepticus and grand mal seizures. It is released in the form of tablets, 10 pieces in a blister, 99.5 mg of the active ingredient in one tablet.

Pharmacological properties

Inhibits convulsive activity, stabilizes the threshold of excitability. It is actively distributed in tissues, secreted by saliva and gastric juice crosses the placenta. Metabolized in the liver.

Indications

Difenin is indicated for the following pathologies:

grand mal seizures;
epileptic status;
violations heart rate with organic lesions of the central nervous system;
overdose of cardiac glycosides;
trigeminal neuralgia.

It is used as a prophylactic to prevent epilepsy in neurosurgery.

Contraindications

It is forbidden to use Difenin in heart failure, atrioventricular blockade, sinus bradycardia. It is not prescribed for liver or kidney failure, porphyria.

It is used with caution in children with rickets, in the elderly and diabetics, in chronic alcoholism. Combination with Delavirdine is contraindicated.

Adverse reactions

In the treatment of drugs based on phenytoin, side effects such as nausea, vomiting, nervousness, dizziness are noted. At laboratory research blood may be marked leukopenia, granulocytopenia, thrombocytopenia, pancytopenia.

Such adverse reactions like thickening of the lips and facial contours, osteoporosis, skin rashes, dermatitis, systemic lupus erythematosus. An allergic reaction is accompanied by anaphylaxis.

Carbamazepine

Preparations based on it are indicated for psychomotor and major convulsive seizures. Carbamazepine is available in tablets with an active ingredient concentration of 0.2 g.

Pharmacological properties

Drugs used for leg cramps and generalized seizures work by blocking sodium channels and reducing synaptic conduction of nerve impulses.

Carbamazepine stabilizes the membranes of nerve fibers and prevents the occurrence of neuronal discharges. The preparation for the legs should be chosen after additional consultations with a cardiologist and a phlebologist.

Indications for use

Carbamazepine is indicated for the following pathologies:

epilepsy;
convulsive attacks;
tonic-clonic seizures;
mixed forms of seizures;
alcohol withdrawal;
acute manic states.

Can be used for neuralgia of the glossopharyngeal and trigeminal nerves as part of complex therapy.

Contraindications

Do not prescribe Carbamazepine to patients with atrioventricular blockade, bone marrow suppression and hepatic porphyria, including tardive skin porphyria. It is forbidden to combine with MAO inhibitors.

Adverse reactions

The most common adverse reactions from the central nervous system are: dizziness, headache, drowsiness, migraine, weakness. Carbamazepine may be accompanied by unwanted effects from the gastrointestinal tract: nausea, vomiting.

Allergic manifestations are characterized by urticaria, skin rashes, vasculitis, lymphadenopathy. In case of violations from other organs as a result of an allergy, the drug should be discontinued.

Clonazepam

Representative of the group of benzodiazepine derivatives. Produced in the form of tablets with a concentration active substance- clonazepam - 2 mg. Contains lactose.

Pharmacological properties

It affects many structures of the central nervous system, the limbic system and the hypothalamus, structures associated with the regulation of emotional functions. Enhances the inhibitory effect of GABA-ergic neurons in the cerebral cortex.

Reduces the activity of noradrenergic, cholinergic, serotonergic neurons. It acts as an anticonvulsant, sedative, anti-anxiety and hypnotic agent.

Indications

The use of Clonazepam is indicated in the following cases:

all forms of epilepsy in adults and children;
epileptic seizures - complex and simple;
secondarily due to simple seizures;
primary and secondary tonic-clonic seizures;
myoclonic and clonic convulsions;
Lennox-Gastaut syndrome;
syndrome of paroxysmal fear.

It can be used to eliminate fears, phobias, in particular the fear of open spaces. It is not used to treat phobias in juvenile patients.

Contraindications

Clonazepam is contraindicated in violation of respiratory function or respiratory failure, with disorders of consciousness and sleep apnea.

It is forbidden to prescribe to patients with acute-angle glaucoma, myasthenia gravis, during breastfeeding. Severe liver and/or kidney dysfunction is a contraindication.

Adverse reactions

The most frequent adverse reactions are observed from the side of the central nervous system: fatigue, muscle weakness, impaired coordination of movements, dizziness. Symptoms are temporary and disappear on their own or when the dosage is reduced.

With long-term treatment, the phenomenon of slow speech and weakened coordination, visual disturbances in the form of double vision develops. Possible allergic reactions.

Lamotrigine

One of the most popular drugs for seizures and epilepsy. Produced in the form of tablets. One tablet contains 25, 50, 100 or 200 mg of lamotrigine.

The preparation also contains lactose monohydrate.

Pharmacological properties

Anticonvulsant drug, the mechanism of action of which is associated with the blocking of voltage-dependent sodium channels of the presynaptic membrane. The drug acts so that glutamate does not enter the synaptic cleft, an amino acid that plays a decisive role in the formation epileptic seizure.

Indications and contraindications

For adults and children over 12 years of age, Lamotrigine is prescribed as the main and additional therapy for epilepsy, including partial and generalized seizures. Effective against tonic-clonic seizures and seizures associated with Lennox-Gastaut syndrome.

Lamotrigine is used in childhood from 2 years according to the same indications.

Contraindication is hypersensitivity to active substance or other ingredients of the drug.

Epilepsy - chronic illness of the brain, characterized by a tendency to form a pathological focus of synchronous discharge of neurons and manifested by large, small seizures and epileptic equivalents.

In the treatment of epilepsy, the principle of monotherapy is used - a life-long intake of one specific drug. Bi- and tritherapy are sometimes used when the patient takes two or more medications. Polytherapy is used when monotherapy with one drug does not work.

Basic Approach

Antiepileptic drugs are a group of drugs that prevent the development of seizures and stop an acute epileptic seizure.

For the first time in clinical practice, bromides were used. Despite their low efficiency, they were prescribed from the middle of the 18th to the beginning of the 20th centuries. In 1912, the drug phenobarbital was first synthesized, but the drug had a wide range of side effects. Only in the middle of the 20th century did researchers synthesize phenytoin, trimethadione, and benzobarbital, which had fewer side effects.

During development, physicians and researchers drew up principles that must be met modern drugs for the treatment of epilepsy:

high activity;
duration of action;
good absorption in the digestive organs;
low toxicity;
influence on most pathological mechanisms epilepsy;
lack of dependence;
no side effects in the long term use.

The goal of any pharmacological therapy is to completely eliminate seizures. But this is achieved only in 60% of patients. The rest of the patients acquire drug intolerance or persistent resistance to antiepileptic drugs.

The disease is based on a pathological process in which a large group of neurons is synchronously excited in the brain, due to which the brain issues uncontrolled and inadequate commands to the body. Clinical picture symptoms depend on the location of the pathological focus. The task of drugs for the treatment of epilepsy is to stabilize the membrane potential of the nerve cell and reduce their excitability.

Anticonvulsants for epilepsy have not been well studied. However, their fundamental principle mechanism of action is known - inhibition of excitation of brain neurons.

Excitation is based on the action of glutamic acid, the main excitatory neurotransmitter of the nervous system. Drugs, such as phenobarbital, block the reception of glutamate in the cell, due to which the electrolytes Na and Ca do not enter the membrane and the action potential of the neuron does not change.

Other agents, such as valproic acid, are glutamine receptor antagonists. They prevent glutamate from interacting with the brain cell.

In the nervous system, in addition to excitatory neurotransmitters, there are inhibitory neurotransmitters. They directly suppress cell excitation. A typical representative of inhibitory neurotransmitters is gamma-aminobutyric acid (GABA). Drugs of the benzodiazepine group bind to GABA receptors and act on them, causing inhibition in the central nervous system.

In the synaptic clefts - in the place where two neurons come into contact - there are enzymes that utilize certain neurotransmitters. For example, after the processes of inhibition, small residues of gamma-aminobutyric acid remained in the synaptic cleft. Normally, these residues are utilized by enzymes and subsequently destroyed. So, for example, the drug Tiagabine prevents the utilization of the remaining gamma-aminobutyric acid. This means that the concentration of the inhibitory neurotransmitter does not decrease after its exposure, and it further inhibits excitation in the postsynaptic membrane of the neighboring neuron.

The inhibitory neurotransmitter gamma-aminobutyric acid is produced by the breakdown of the excitatory neurotransmitter glutamate by the enzyme glutamate decarboxylase. For example, the drug Gebapantin accelerates the utilization of glutamate to produce more gamma-aminobutyric acid.

All of the above drugs affect indirectly. However, there are drugs (carbamazepine, phenytoin or valproate) that directly affect cell physiology. The neuron membrane has channels through which positively and negatively charged ions enter and exit. Their ratio in the cell and around it determines it, the cell, the membrane potential and the possibility of subsequent inhibition or excitation. Carbamazepine blocks voltage-gated channels and prevents them from opening, as a result of which ions do not enter the cell and the neuron is not excited.

The list of drugs shows that the doctor has a modern arsenal of antiepileptic drugs different groups, which affect many mechanisms of excitation and inhibition of the cell.

Classification

Antiepileptic drugs are classified according to the principle of influence on the mediator and ionic systems:

Drugs that enhance the activity of inhibitory neurons by stimulating and increasing the amount of gamma-aminobutyric acid in the synaptic cleft.
Drugs that inhibit the excitation of neurons by inhibiting glutamic acid receptors.
Drugs that directly affect membrane potential by acting on voltage-gated ion channels nerve cells.

New generation drugs

There are three generations of antiepileptic drugs. The third generation is the most modern and studied means in the treatment of the disease.

Antiepileptic drugs of the new generation:

Brivaracetam.
Valrocemide.
Ganaxolone.
Caraberset.
Karisbamat.
Lacosamide.
Losigamon.
Pregabalin.
Retigabalin.
Rufinamide.
Safinamide.
Seletracetam.
Serotolid.
Stiripentol.
Talampanel.
Fluorofelbamate.
Phosphenition.
DP-valproic acid.
Eslicarbamazepine.

13 of these drugs are already being tested in laboratories and clinical trials. In addition, these drugs are being studied not only as effective treatment epilepsy, but also others mental disorders. The most studied and already studied drugs are Pregabalin and Lacosamide.

Possible side effects

Most antiepileptic drugs suppress the activity of neurons, causing inhibition in them. This means that the most common effect is central nervous system sedation and relaxation. Means reduce the concentration of attention and the speed of psychophysiological processes. These are non-specific adverse reactions that are characteristic of all antiepileptic drugs.

Some of the remedies have specific side effects. For example, phenytoin and phenobarbital in some cases provoke cancer diseases blood and softening bone tissue. Preparations based on valproic acid cause trembling of the extremities and dyspeptic symptoms. When taking Carbamazepine, visual acuity decreases, double vision and swelling of the face appear.

Many drugs, in particular drugs based on valproic acid, increase the risk of defective fetal development, so these drugs are not recommended for pregnant women.

Anticonvulsant drugs are used as a means to eliminate pain symptoms and muscle spasms, to prevent the transition from a state of pain attacks to convulsive and.

Activation nerve impulse simultaneously by a group of certain neurons is similar to the signal given by motor-type neurons in the cerebral cortex. In the event of a lesion of this type, the nerve endings do not appear in tics or convulsions, but cause bouts of pain.

The purpose of the use of anticonvulsants is to eliminate pain or muscle spasms without provoking oppression of the central nervous system. Depending on the complexity of the disease, these drugs can be used from several years to lifelong use in severe chronic or genetic forms diseases.

Attacks of convulsive activity are associated with an increase in the degree of excitation of nerve endings in the brain, usually localized in certain areas of its structure and diagnosed upon the onset of a condition characteristic of the onset.

The cause of seizures can be a deficiency in the body of the necessary chemical elements such as magnesium or potassium, pinching of a muscular nerve in a canal, or sudden, prolonged exposure to cold. Deficiency of potassium, calcium or magnesium provokes failures in the transmission of signals to the muscles from the brain, as evidenced by the occurrence of spasms.

AT initial stage manifestation of the development of a disease of a neurological type consists in local painful sensations, emanating from the area of the affected nerve cells and manifested by bouts of pain of varying strength and nature of manifestation. With the course of the disease due to the development inflammatory processes or muscle spasms in the area of pinched nerve endings, the strength of the attacks increases.

In the case of an early appeal to a specialist, a complex of drugs is used for therapy, eliminating the causes and signs of damage to the nerve endings. Self-diagnosis and treatment does not allow you to choose from a wide range anticonvulsant drugs are most suitable for stopping pain symptoms and eliminating the cause of discomfort.

Most of the drugs used in the treatment of seizures have combined effects and have many contraindications, on the basis of which, the unauthorized prescription and use of these drugs can pose a danger to the patient's health.

When observed by a specialist, he evaluates the work of the prescribed drug by its effectiveness and diagnoses the absence of pathological changes after taking it according to the results of blood tests.

Fundamentals of anticonvulsant therapy

Part complex treatment with convulsive manifestations, there are groups of drugs of various principles of action, including:

Some of the prescribed drugs have the effect of inhibiting the development or preventing the occurrence of allergic-type reactions.

The main groups of anticonvulsants

Anticonvulsants are divided into several groups, a list of which is offered below.

Iminostilbenes

Iminostilbenes are characterized by an anticonvulsant effect, after their use, pain symptoms are eliminated and mood is improved. The drugs in this group include:

Tegretol;
Amizepine;
Zeptol.

Sodium valproate and derivatives

Valproates, used as anticonvulsants and as iminostilbenes, help to improve the emotional background of the patient.

In addition, when using these drugs, tranquilizing, sedative and muscle relaxant effects are noted. The drugs in this group include:

Acediprol;
sodium valproate;
Valparin;
Convulex;
Epilim;
Apilepsin;
Diplexil.

Barbiturates

Barbiturates are characterized by a sedative effect, help lower blood pressure and have hypnotic effect. Among these drugs, the most commonly used are:

Benzobamyl;
Benzamyl;
Benzoylbarbamyl;
Benzoal.

Benzodiazepines

Anticonvulsants based on benzodiazepine have a pronounced effect, they are used in the event of the appearance of convulsive conditions in epilepsy and prolonged attacks of neuralgic disorders.

These drugs are characterized by sedative and muscle relaxant effects, with their use, normalization of sleep is noted.

Among these drugs:

Antilepsin;
Klonopin;
Ictoril;
Ravatril;
Ravotril;
Rivotril;
Ictorivil.

Succiminides

Anticonvulsants of this group are used to eliminate muscle spasms. individual bodies with neuralgia. When using drugs in this group, sleep disturbances or nausea are possible.

Among the most used means are known:

Pufemid;
Suxilep;
Succimal;
Ronton;
Etimal;
Ethosuximide;
Pycnolepsin.

Anticonvulsants used for leg cramps:

Valparin;
Xanax;
Difenin;
Antinerval;

Hitting the nine convulsive "gates"

The main anticonvulsants that are most often used for epilepsy, convulsive seizures and neuralgia of various origins:

Practical experience of consumers

What is the situation with anticonvulsant therapy in practice? This can be judged by the reviews of patients and doctors.

I am taking Carbamazepine as a replacement for Finlepsin because foreign analogue it costs more, and the domestically produced drug is excellent for therapy for my illness.

Since I have tried both drugs, I can say about high efficiency both, however, a significant difference in cost is a significant disadvantage of foreign funds.

Ivan

After several years of taking Finlepsin, on the advice of a doctor, I changed it to Retard, since the specialist believes that this drug is more suitable for me. I had no complaints while taking Finlepsin, however, in Retard, in addition to similar action there is a sedative effect.

In addition, the drug is characterized by great ease of use, since, compared with analogues, it must be taken not three times a day, but once.

Victor

Voltaren helps with pain syndromes medium severity. It is good to use it as an addition to the main treatment.

Luba

Time to collect stones

A distinctive feature of anticonvulsants is the impossibility of a quick end of their intake. With a noticeable effect from the action of the drug, the term for canceling its use is up to six months, during which there is a gradual decrease in the rate of taking the drug.

According to the popular opinion of doctors, the most effective drug for the treatment of seizure activity is carbamazepine.

Less effective are drugs such as Lorazepam, Phenytoin, Seduxen, Clonazepam, Dormicum and valporic acid, arranged in order of decreasing therapeutic effect.

It remains to be added that it is impossible to obtain anticonvulsants without prescriptions, which is good, since it is very dangerous to take them irresponsibly.