Antiepileptic drug mechanisms of action.
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, GABAA 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 GABAA 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.
Macdonald
R L
RL
Department of Neurology, University of Michigan Medical Center, Ann Arbor.
Kelly
K M
KM
D000085:Acetates / Q000494:pharmacology; D000200:Action Potentials / Q000187:drug effects; D000588:Amines; D000927:Anticonvulsants / Q000494:pharmacology*; D015220:Calcium Channels / Q000187:drug effects; D003509:Cyclohexanecarboxylic Acids; D015195:Drug Design; D004829:Epilepsy, Generalized / Q000188:drug therapy; D000077206:Gabapentin; D006801:Humans; D007473:Ion Channels / Q000187:drug effects*; D000077213:Lamotrigine; D011963:Receptors, GABA-A / Q000187:drug effects; D017981:Receptors, Neurotransmitter / Q000187:drug effects*; D015222:Sodium Channels / Q000187:drug effects; D014227:Triazines / Q000494:pharmacology; D014635:Valproic Acid / Q000494:pharmacology; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D000927:Anticonvulsants; D015220:Calcium Channels; D003509:Cyclohexanecarboxylic Acids; D007473:Ion Channels; D011963:Receptors, GABA-A; D017981:Receptors, Neurotransmitter; D015222:Sodium Channels; D014227:Triazines; D005680:gamma-Aminobutyric Acid; D014635:Valproic Acid; D000077206:Gabapentin; D000077213:Lamotrigine