Mechanism of action of newer anticonvulsants.
Bipolar disorder, like epilepsy, is episodic in nature. It should not be surprising, then, that anticonvulsants such as carbamazepine and valproate have proven efficacy as mood stabilizers. The newer anticonvulsants-agents like lamotrigine, gabapentin, topiramate, oxcarbazepine, and zonisamide-may also be effective treatments for bipolar disorder. Identifying an anticonvulsant for use in bipolar disorder should take into account not only the pathophysiology of bipolar disorder but also the mechanism of action of the anticonvulsant. This article will explore the mechanisms of action of the newer anticonvulsants and their relationship to the pathophysiology of bipolar disorder in an attempt to determine which of these agents might make effective mood stabilizers.
White
H Steve
HS
Department of Pharmacology and Toxicology, University of Utah, Salt Lake City 84112, USA. swhite@hsc.utah.edu
D000818:Animals; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D018692:Antimanic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000503:physiopathology*; D001921:Brain / Q000187:drug effects* / Q000503:physiopathology; D015220:Calcium Channels / Q000187:drug effects / Q000502:physiology; D002257:Carbonic Anhydrase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D002256:Carbonic Anhydrases / Q000378:metabolism; D006801:Humans; D018377:Neurotransmitter Agents / Q000378:metabolism*; D018091:Receptors, AMPA / Q000037:antagonists & inhibitors / Q000502:physiology; D011963:Receptors, GABA-A / Q000187:drug effects / Q000502:physiology; D018092:Kainic Acid Receptors / Q000187:drug effects / Q000502:physiology; D015222:Sodium Channels / Q000187:drug effects / Q000502:physiology; D013329:Structure-Activity Relationship; D016896:Treatment Outcome
D000927:Anticonvulsants; D000928:Antidepressive Agents; D018692:Antimanic Agents; D015220:Calcium Channels; D002257:Carbonic Anhydrase Inhibitors; D002256:Carbonic Anhydrases; D018377:Neurotransmitter Agents; D018091:Receptors, AMPA; D011963:Receptors, GABA-A; D018092:Kainic Acid Receptors; D015222:Sodium Channels