Second-Generation Anti-Epileptic Drugs

This article is about Second-Generation Anti-Epileptic Drugs, which are used to treat different types of epilepsy. Despite the fact that epilepsy is a serious chronic disease, it can be successfully treated in 70% of cases. Medications allow the course of the disease to be controlled with confidence in a large number of patients. Other therapeutic measures (special diet, work and rest regime) are in addition to the basic therapy. Treatment begins with the diagnosis of epilepsy by a specialist and should not be prescribed alone.

The mechanism of action of drugs

Epilepsy is associated with the emergence of a persistent focus of excitation in the human brain. A large group of closely spaced neurons (the main functional cells of the brain) too actively generates electrical potentials, and they then spread to other parts of the brain.

In order to understand how the drugs work, we need to say a few words about the signal transmission between neurons. The electrical signal travels along a nerve fiber. The current in the fiber is produced by the alternating opening and closing of ion channels on the surface of the cell. When sodium and calcium enter the nerve cell through specialized channels and potassium tends to leave the cell, a charge difference arises on the membrane of the neuron, which is the nerve signal that travels along the nerve fiber. When the electrical discharge reaches the end of the nerve fiber, a neurotransmitter – a special substance that transmits the signal to another neuron – is released into the synaptic cleft. The neurotransmitter can excite the cell (for example, glutamate) or decrease its activity (gamma-aminobutyric acid).

All drugs can be divided into two large groups – traditional (basic) drugs and the so-called new drugs obtained relatively recently. At the same time, we cannot say unequivocally that the new drugs are better than the traditional ones; the drugs synthesized earlier have been studied more thoroughly. Doctors are well aware of their side effects and interactions with other drugs. The emergence of new molecules has to do with finding drugs for cases where traditional drugs have not worked. New drugs are now often used as an adjunct to basic therapy to the underlying drug. 

Antiepileptic drugs are one way to treat epilepsy. The most common forms of release are capsules, tablets, and granules for oral administration. They in turn are divided into drugs of immediate and delayed release. The first have an important disadvantage: the rapid rise in concentration of the drug and its subsequent decrease. As a result, the drug has a stronger effect on the body at the beginning of its stay in the body, but it quickly decreases after reaching the peak concentration. With the subsequent decrease of the drug in the blood, its effect on the central nervous system decreases.

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