Wednesday, October 18, 2017 14:53

How Do Drugs For Epilepsy Works

Posted by on Tuesday, October 20, 2009, 15:53
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Epilepsy drugs actually have many different actions in the brain. All, however, have the potential to affect the transmissions of abnormal signals between neurons that cause of seizures. Simply shutting down all transmissions among the malfunctioning neurons would clearly stop seizures, but this would also shut down all normal brain processes associated with those neurons as well.

The trick is to calm that abnormal activity without affecting normal thinking and alertness.

Many drugs that are effective for partial seizures affect a specific chemical channel of the neuron: the sodium channel. This is a “gate” through which sodium ions can rush into the cells and is needed for the neuron to fire. Drugs such as phenytoin, carbamazepine, and lamotrigine affect this channel to prevent neurons from firing rapidly. Other drugs, such as valproic acid, ethosuximide, and levetiracetam, act on calcium channels.

Phenobarbital and benzodiazepines act through a specific type of neuron that uses gamma-aminobutiric acid as its transmitter. GABA neurons are usually part of an inhibitory system, and drugs affecting GABA probably work by improving the brain’s self calming ability to quell seizures.

Still other drugs, such as topiramate and felbamate, decrease excitatory pathways. All drugs are better at preventing the spread of seizures than at preventing their initiation, so that small seizures are sometimes the most difficult to completely eliminate.

Although there are theories, it is not known precisely how these drugs work. Some actually seem to have several actions that could potentially calm seizures, other do not have any of these known actions yet are still effective anticonvulsants. As the mechanism of the drugs and the precise abnormality in individual people are not well understood, finding the right match between medication and person is sometimes a process of trial and error.

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