Anti-convulsant Agents: Definition and Indication

Abstract

Anti-convulsant agents are a group of drugs that are administered to prevent the recurrence of epileptic seizures or at least reduce seizure frequency. More often the term “antiepileptic drug” (AED) is used. They belong to the most often prescribed centrally active agents. The first developed anti-convulsant drug was potassium bromide, the anticonvulsive action of which was discovered in 1857. From that time on, a large variety of AEDs were discovered, driven by serendipity in the beginnings of anti-convulsant drug development and increasingly focused on biochemical principles since the mid-twentieth century. Today, the clinician has the choice between more than 20 anti-convulsant drugs, and there is no drug that fits it all. Epilepsy is not a unique disease, but rather a symptom-driven definition of a brain dysfunction based on countless different affections of the brain. Thus, therapy with AEDs is anticonvulsive therapy in epilepsy, not antiepileptic therapy. According to that, numerous aspects such as seizure type, epilepsy syndrome, age, sex, comorbidity, and comedication of the patient must be considered when choosing the best drug in the individual case.

Unfortunately, the main goal of anti-convulsant therapy – the disappearance of seizures without the appearance of undesired side effects – is not always achieved. Up to one third of patients will have ongoing seizures under anti-convulsant treatment, and other therapies like epilepsy surgery come into focus. If this possibly curing therapy is unfeasible, improvement of patient’s quality of life remains the key. The latter depends on the right AED for the individual patient.

Besides their use in epilepsy, anti-convulsant drugs are used in a wide spectrum of neuropsychiatric diseases such as neuropathic pain, migraine headache, anxiety, and bipolar disorder.