title: [How do antiepileptic drugs work?].
abstract: BACKGROUND
  There are currently around 25 antiepileptic drugs in use in Norway, of which 15 have entered the market in the last 20 years. All have somewhat different effect- and adverse effect profiles and mechanisms of action. Here we present a brief overview of current knowledge regarding the basic mechanisms of action of these drugs.
  
  
  METHODS
  The review is based on a discretionary selection of relevant articles found through a literature search in PubMed and our own clinical and research experience.
  
  
  RESULTS
  There are, roughly speaking, four main mechanisms; 1) modulation of ion channels (sodium and calcium channel blockers, potassium channel openers), 2) potentiation of GABAergic inhibition, 3) reduction of glutamatergic excitation and 4) modulation of presynaptic neurotransmitter release. Some of the drugs have several mechanisms of action, and for some of them it is unclear which mechanism is clinically most important. To some extent, the drugs' mechanisms of action predict their effect against different types of epilepsy and seizures. For instance, sodium channel blockers work best against focal seizures, while calcium channel blockers work best against absences, a type of generalised seizure.
  
  
  CONCLUSIONS
  Optimal treatment of patients with epilepsy requires not only thorough knowledge of seizure- and epilepsy classification, but also insight into the mechanisms of action of antiepileptic drugs.
authors.forename: Karl O
authors.initials: KO
authors.lastname: Nakken
authors.forename: Kjell
authors.initials: K
authors.lastname: Heuser
authors.forename: Kristin
authors.initials: K
authors.lastname: Alfstad
authors.forename: Erik
authors.initials: E
authors.lastname: Taubøll
mesh_terms: D000927:Anticonvulsants / Q000494:pharmacology*; D004827:Epilepsy / Q000188:drug therapy*; D018682:GABA Agents / Q000494:pharmacology; D006801:Humans; D049990:Membrane Transport Modulators / Q000494:pharmacology; D058468:Receptors, Ionotropic Glutamate / Q000037:antagonists & inhibitors; D017661:Receptors, Presynaptic / Q000187:drug effects
chemical_list: D000927:Anticonvulsants; D018682:GABA Agents; D049990:Membrane Transport Modulators; D058468:Receptors, Ionotropic Glutamate; D017661:Receptors, Presynaptic