Dorothy FarrarAnticonvulsants
Anticonvulsants , or antiepileptic drugs, are drugs used to treat epileptic disorders. Epilepsy is a chronic disease caused by a disorder in the brain. The build-up of excitation in the brain is abnormal and triggers epileptic seizures.
What are anticonvulsants?
Anticonvulsants are drugs used to treat epileptic disorders or seizure disorders. These medicines are also often referred to as antiepileptics. Epilepsy is a medical condition associated with at least one spontaneously occurring seizure. It should also be noted that the seizure is not the result of acute inflammation when making the diagnosis. The medical use of anticonvulsants dates back to 1912. The neurologist Alfred Heuptmann used a drug previously used as a sleep aid to treat epileptic diseases.
In most cases, long-term therapy with anticonvulsant preparations is necessary for treatment. Antiseizure drugs cannot cure the disease, but they try to prevent the seizures. Regular intake is important for good effectiveness. Taking too little or stopping the drug suddenly can trigger an attack. Interactions with other medications are possible, such as birth control pills.
Effect and medical application
The symptoms of epileptic seizures are diverse. Therefore, the effect of the different medicines used for treatment is also different. What all medicines used to treat epilepsy have in common is that they suppress epileptic seizures. However, they do not cure the disease. Excitations in the central nervous system are described as the cause of seizures .
An epileptic seizure is therefore the result of synchronous neuron group discharges in the human brain . These lead to involuntary symptoms or behavioral disorders in epileptics . Those affected convulse, bite their tongue, lose consciousness , and urinate or defecate. Depending on the severity of the disease, not all symptoms always appear.
A seizure can range from a mild disturbance of consciousness, known as an absence, to a “grand mal” seizure. Antiepileptic drugs are intended to both treat the acute attack and prevent further attacks. They inhibit the transmission of excitation in the central nervous system. They block Ca+ and Na+ channels. When these channels are blocked, the neurons lose the ability to transmit spasmodic stimuli. At the same time, they reinforce GABA-mediated inhibitory mechanisms.
GABA, or gamma-aminobutyric acid, is a neurotransmitter in the central nervous system and the most important anti-seizure substance in the brain. Its action is enhanced by anticonvulsant drugs. Neurotransmitters transmit or amplify stimuli from one cell in the nervous system to another cell. Other areas of application for antiepileptics are febrile convulsions , preventing seizures during brain surgery or in preparation for anesthesia .
shapes and groups
There are different forms and groups of anticonvulsants. Carbamazepine (Timonil®) is a common drug and first choice in the treatment of epileptic diseases. Valproate (Ergenyl®) is another drug of first choice in long-term therapy. Drugs of second choice in long-term therapy are phenytoin (Phenhydan®), ethosuximide (Penidan®) and phenobarital (Luminal®). If these drugs do not work satisfactorily, the drug primidone (Mylepsinum®) can be used. Diazepam (Valium®) or lorazepam (Tavor®) may be given to treat status epilepticus or an acute seizure. Relatively new anticonvulsants include vigabatrin (Sabril®), topirament (Topamax®), levetiracetam (Keppra®), and lamotrigine (Lamictal®).
dosage
Each anticonvulsant has a specific mechanism of action. The primary goal of therapy is to prevent seizures. For this purpose, a suitable drug and the right dosage must be determined individually for each person affected. The dosage varies from patient to patient. However, the package inserts for the medication specify a dosage framework. In general, an anticonvulsant is dosed up to the side effect limit. If the medicine does not have the desired effect, the patient is treated with another preparation.
Antiepileptic treatments should be given as monotherapy whenever possible. This means that the disease should only be treated with a single active ingredient. If monotherapy is not sufficient, combination therapy can be used. Most anticonvulsants have to be taken over a longer period of time, so regular blood value checks are essential. You should never stop taking these medicines yourself. In order to gradually taper off these drugs, it is usually necessary to gradually reduce the dosage over a longer period of time.
Herbal, natural and pharmaceutical alternatives
In many cases, therapy for epilepsy cannot be avoided without anticonvulsants. In some cases, a change in lifestyle, such as the sleeping rhythm , is helpful. Some patients manage to recognize an incipient seizure and can stop it with the help of psychotherapeutic methods. Some epileptics can also assess the circumstances under which seizures often occur and should avoid them.
If, despite consistent drug treatment, seizure freedom cannot be achieved in the affected person, it is possible in some cases to treat the epilepsy surgically. Suitable candidates for such surgery are patients whose seizures originate from as small an area of the brain as possible. This brain region can then be removed. Furthermore, in a few patients, a division of the cerebral hemispheres makes sense. The process in the brain that triggers a seizure is thus interrupted. Brain stimulation is also possible. Electrodes implanted in the brain are intended to stimulate certain regions and thus prevent a seizure.
Interactions and side effects
Anticonvulsants are usually well tolerated. However, possible side effects include allergic reactions , impaired movement coordination, fatigue and dizziness . Some substances have a pronounced effect on the heart , liver and kidneys and must therefore not be given if there is an existing disease in these organs. These include phenytoin, phenymazepine and lamotrigine. Taking anticonvulsants during pregnancy should be viewed critically.
Many antiepileptic substances can harm the unborn child and/or lead to a developmental disorder. Interactions with other medicines are not uncommon and must be taken into account when hiring the person concerned. For example, they weaken the effectiveness of hormonal contraceptives , such as the birth control pill .
Little long-term damage is to be expected from the medication. Possible long-term side effects, such as low-calcareous bones, can be ruled out by regular medical check-ups.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.