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Antiepileptic Drug Mechanisms of Action

1993; Wiley; Volume: 34; Issue: s5 Linguagem: Inglês

10.1111/j.1528-1157.1993.tb05918.x

1528-1167

Robert L. Macdonald, Kevin M. Kelly,

Epilepsy research and treatment

Summary: Clinically used antiepileptic drugs (AEDs) decrease membrane excitability by interacting with ion channels or neurotransmitter receptors. Currently available AEDs appear to act on sodium channels, GABA A receptors, or calcium channels. Phenytoin, carbamazepine, and possibly valproate (VPA) decrease high‐frequency repetitive firing of action potentials by enhancing sodium channel inactivation. Benzodiazepines and barbiturates enhance GABA A receptor‐mediated inhibition. Ethosuximide and possibly VPA reduce a low‐threshold calcium current. The mechanisms of action of AEDs currently under development are less clear. Lamotrigine may decrease sustained high‐frequency repetitive firing. The mechanisms of action of felbamate are unknown. Gabapentin (GBP) appears to bind to a specific binding site in the central nervous system with a restricted regional distribution, but the identity of the binding site and the mechanism of action of GBP remain uncertain.