Table 5.
Excitatory Transmission | Na+ Channels | Ca2+ Channels | K+ Channels | Glutamate Receptors | 5-HT Receptors | Sigma-1 Receptors | Inhibitory Transmission | GABA-A Receptors | GABA Turnover | GABA-B Receptors | SV2A Binding | Carbonic Anhydrase | Clinical Efficacy | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Barbiturates | YES | YES | BS | |||||||||||
Benzodiazepines | YES | YES | BS | |||||||||||
Brivaracetam | YES | FS | ||||||||||||
Cannabidiol | YES | LGS, DS | ||||||||||||
Carbamazepine | YES | YES | YES | FS, GTCS | ||||||||||
Cenobamate | YES | YES | YES | FS (adult) | ||||||||||
Clobazam | YES | YES | YES | LGS, FS | ||||||||||
Eslicarbazepine | YES | YES | FS | |||||||||||
Ethosuximide | YES | YES | ABS | |||||||||||
Felbamate | YES | YES | YES | YES | YES | YES | BS | |||||||
Fenfluramine | YES | YES | YES | DS | ||||||||||
Gabapentin | YES | YES | YES | YES | YES | FS, GTCS | ||||||||
Lacosamide | YES | YES | YES | FS, SGS | ||||||||||
Lamotrigine | YES | YES | YES | FS, GCTs, ABS | ||||||||||
Levetiracetam | YES | YES | YES | YES | YES | YES | BS | |||||||
Oxcarbazepine | YES | YES | YES | YES | FS, GTCS | |||||||||
Perampanel | YES | YES | FS, GTCS | |||||||||||
Phenobarbital | YES | YES | YES | YES | YES | FS | ||||||||
Phenytoin | YES | YES | YES | FS, GTCS | ||||||||||
Pregabalin | YES | YES | YES | FS | ||||||||||
Primidone | YES | YES | YES | YES | FS, GTCS | |||||||||
Retigabine | YES | YES | FS | |||||||||||
Rufinamide | YES | YES | LGS | |||||||||||
Stiripentol | YES | YES | DS | |||||||||||
Tiagabine | YES | YES | FS | |||||||||||
Topiramate | YES | YES | YES | YES | YES | YES | YES | YES | BS | |||||
Valproate | YES | YES | YES | YES | YES | YES | BS | |||||||
Vigabatrin | YES | YES | FS, ES | |||||||||||
Zonisamide | YES | YES | YES | YES | FS, GTCs, MYO |
ABS, absence; BS, broad spectrum; DEE, developmental and epileptic encephalopathy; DS, Dravet syndrome; ES: epileptic spasms; FS, focal seizures; GABA, γ-aminobutyric acid; GTCS, generalized tonic-clonic seizures; 5-HT, 5-hydroxytryptamine; LGS, Lennox–Gastaut syndrome; MYO: myoclonic, SGS: secondary generalized seizures; SV2A, synaptic vesicle protein 2. Adapted from https://www.uptodate.com/contents/antiseizure-drugs-mechanism-of-action-pharmacology-and-adverse-effects.