|
Drug
|
Chemistry
|
Mechanism of action
|
Metabolism
|
Possible adverse effects
|
Characteristics
|
|
Topiramate
|
Sulfamate-substituted monosaccharide, broad spectrum AED
|
Blocks voltage dependent sodium ions. Inhibit GABA
|
70% excreted
and 30% metabolized
|
Weight loss, cognitive problems,
metabolic acidosis
|
Never withdraw drug promptly, but gradually
|
|
Vigabatrin
|
Structural analogue of GABA
|
Inhibits GABA transaminase
|
Renal
|
Insomnia,
visual field defects,
weight gain
|
Has been also used for infantile spasms
|
|
Stiripentol
|
AED used with other drugs, such as valproate, for the treatment of
tonic-clonic seizures
|
Increases GABA release
|
Metabolized in liver
|
Minor central nervous system (CNS) effects
|
Not frequently prescribed
|
|
Zonisamide
|
Sulphonamide derivative that facilitate dopamine and serotonin
transmission across blocked calcium channels
|
Acts on sodium channels and voltage dependent calcium channels
|
Metabolized in liver
|
Weight loss, CNS side effects, ataxia
|
Have drug interactions
|
|
Rufinamide
|
Triazole derivative,
mechanism not exactly known
|
Prolongs inactive state of sodium channels
|
Metabolized in liver
|
CNS side effects
|
Not given to patients of familial short QT syndrome
|
|
Levetiracetam
|
Broad spectrum AED
|
Inhibits calcium channels,
also lessens the calcium release from intraneuronal stores
|
Renal and enzymatic
|
Behavioral disturbances,
headache,
anorexia
|
Favorable safety profile, safe for liver disease patients
|
|
Lacosamide
|
Functionalized amino acid, AED used both oral and intravenous
|
Increases fraction of sodium channels for depolarization
|
Metabolized in liver
|
Nausea,
Diplopia,
CNS affected
|
Hypothesized to produce a neuroprotective effect
|
|
Lamotrigine
|
Broad spectrum AED, half-life affected by enzyme induced drugs
|
Inhibits voltage gated sodium channels
|
Metabolized in liver
|
Allergic reactions,
|
Can cause myoclonic seizures
|
|
Oxcarbazepine
|
10-keto analogue of
carbamazepine
|
Inhibits voltage gated sodium channels
|
Metabolized in liver to active metabolite
|
Dizziness,
CNS side effects,
hyponatremia
|
Can make myoclonia worse
|
