Antiepileptic tablets are available in. Effective remedies for epilepsy. New generation drugs

Updated: 10/10/2019 14:57:59

Judge: Boris Kaganovich

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You do not need to have a medical background to understand what convulsions are. All of them were with each of us. A cramp is a painful, unpredictable, and involuntary contraction of skeletal muscles. But it happens that the muscle just trembles slightly. So, for example, the eye can spontaneously twitch, or rather, the eyelid. This is not a spasm, but fasciculation, that is, not a synchronous involuntary contraction of the entire muscle, but a trembling of individual fibers that are innervated by a small motor branch. This can be disturbing and annoying, but more often than not, it does not apply to the topic of the article.

What are seizures?

Here is an example of true, but local convulsions. Elderly people, as well as patients with heart failure and edema, often take diuretics. Very famous and effective Furosemide, or Lasix, which has a pronounced diuretic effect. But at the same time, it has an important drawback: it also removes potassium from the body along with the liquid. Therefore, if you take it in a large dose, and at the same time do not compensate for the future loss of potassium by (tablets Panangin or Asparkam), then you can achieve a state of hypokalemia, in which the concentration of potassium in the blood plasma decreases. A characteristic symptom of hypokalemia after taking diuretics will be convulsions, most often at night, and most often in the calf muscles. This is the most common cause of seizures from unauthorized diuretic overdose.

A physiological cramp can also occur when swimming in cold water, based on the tonic contraction reflex - an order for intensive work in conditions of vasospasm and lack of nutrients.

To these examples, one can add a number of other reasons that are familiar to doctors. It:

meningitis, or an inflammatory disease of the meninges;
encephalitis, inflammation of the substance of the brain;
febrile seizures in children, which are safe, but which are very feared by parents;
tonic convulsions in tetanus, which are so severe that even bones break.

But in the present material, we will talk about completely different convulsions, and about other medicines - not about Panangin, and not about anesthetics that stop opisthotonus (diffuse convulsions) with tetanus. They help with those cramps that are not born in the muscle itself or in the muscle group, but in the cerebral cortex. Simultaneous synchronous discharge of motor or sensory neurons, a focal or general "flash" leads to the occurrence of either a convulsive syndrome in all its diversity, or non-convulsive equivalents (sensitive aura, vegetative). This disease is called epilepsy, or epilepsy. But there is also an episyndrome. What is it, and what is its difference?

Epilepsy or episyndrome?

In addition to epilepsy, which is considered a primary disease with completely unclear causes, a convulsive syndrome (episindrome) can also be provoked by another pathology, such as a brain tumor, or a tumor of the meninges, which periodically compresses and irritates the cerebral cortex. Such a condition in which there is a clear cause of irritation of the cortex is not called epilepsy, but episyndrome. The episyndrome is considered a secondary phenomenon, and it is important to find this cause in time. Quite often, this syndrome occurs as a result of severe traumatic brain injury, as a consequence of purulent encephalitis and meningitis, and in other conditions. If, despite all the persistent search for a cause, they were unsuccessful, and the patient has a periodically obvious clinic of seizures, or their equivalents, then a diagnosis of epilepsy is made.

The role of the EEG in the diagnosis of epilepsy

For the diagnosis of epilepsy and episyndrome, there is, in addition to the obvious clinic, only one, but very accurate method of instrumental diagnostics, which is used in different versions. This is an EEG recording, or electroencephalogram, which captures the biocurrents of brain neurons. If there are special, pathological rhythms on the encephalogram, for example, peak-wave complexes, then the patient has an increased convulsive readiness and epileptic activity. Such a person will not be given permission to drive a car, he cannot serve in the armed forces, he will not be a pilot, because at any moment this convulsive readiness, registered on an encephalogram, can manifest itself as a real seizure. There are also non-convulsive equivalents, which also need to be treated.

Here, for the treatment of epilepsy, and seizures caused by focal discharges of various parts of the cerebral cortex, there are anticonvulsant drugs. Their other name is antiepileptic drugs, AEDs.

You should not think that long-term, and sometimes lifelong treatment with an established diagnosis of epilepsy with these drugs is only aimed at preventing the onset of a convulsive syndrome, although this is also very important. Taking antiepileptic drugs can prevent the development of characteristic personality changes, which are called epileptoid psychopathy. It is characterized by vindictiveness, excessive pathological thoroughness, scrupulousness, suspiciousness, an absurd contrast in the use of diminutive nouns (“knife”, “bed”) in everyday life, combined with cruelty.

Epilepsy is a fairly frequently diagnosed disease and is a social problem for developed countries. So, in the USA, about 1% of the population has various diagnoses related to this disease, and more often only stroke is diagnosed with epilepsy. In total, there are about 50 million patients in the world, and the frequency of occurrence in Russia is on average 7 cases per 2000 population, or 1 case per 285 people. This is quite a lot, and PEPs are in demand. Before considering anticonvulsants and their effect on the body, a little from the history of the treatment of epilepsy.

From the history of epilepsy treatment

Perhaps the real, scientific epilepsy began in the middle of the 19th century. Prior to this, the sick were isolated, lived in monasteries, were considered holy fools or soothsayers of the truth. True, sometimes they were tried to be treated with trepanation of the skull, which more often ended in death.

The first successful drug that was actually effective was potassium bromide, and bromine compounds began to be used as sedatives and anticonvulsants. The reason for prescribing bromine preparations was one of the false theories, which believed that epilepsy was due to excessive sexual desire, and the patient should be reassured. With bromine, they simply “guessed”, just like with other means. For about 50 years, epilepsy was treated with bromine preparations, but they do not possess true anticonvulsant activity, and only depress the functions of the central nervous system.

But with the beginning of the 20th century, the first drug with true anticonvulsant activity from the group of barbiturates, called phenobarbital, was discovered. It has been used for many decades to treat various forms of epilepsy, and is still used today, albeit with serious limitations. Surprisingly, phenobarbital is the only over-the-counter drug from the barbiturate group in Russia that can be purchased completely freely, though not in its pure form. It is part of the usual Valocordin or Corvalol, along with mint oil, hop oil, ethyl bromoisovalerianate and ethyl alcohol, providing a sedative and hypnotic effect.

Then the discoveries rained down, as if from a cornucopia. In the thirties, phenytoin was found, in the late sixties - carbamazepine, which is still considered the "gold standard" in the treatment of epilepsy. Then, since the eighties and nineties, antiepileptic drugs of the 2nd and 3rd generation began to be used in treatment regimens. This article discusses the most famous means belonging to the first and second generations - an accessible and popular language.

All drugs for the treatment of epilepsy must prevent the spontaneous development of a general impulse that affects the entire neuron. To do this, it is necessary to reduce the activity of neurons, that is, to reduce the action potential, and the ability of the nerve cell to receive from other neurons and transmit excitation. This is achieved by various mechanisms. First, antiepileptic drugs of the first generation will be considered, and then more modern ones. For each medicinal product, synonyms and commercial names registered in the Russian Federation will be given. For drugs, the range of retail prices relevant for pharmacies of all forms of ownership in the Russian Federation for September 2019 will be given.

Overview of modern drugs for seizures (antiepileptic drugs, AEDs)

PEP first generation

Surprisingly, all the antiepileptic activity of the first generation drugs was discovered as a result of random studies. There were no targeted searches or modifications of already known drugs in search of higher activity. Incidentally, phenobarbital, phenytoin, valproate, ethosuximide and other drugs were found. Let's consider those that still help patients, even with severe forms of epilepsy, and in some cases they are still preferred by epileptologists even to the latest drugs.

Carbamazepine (Finlepsin, Tegretol)

Carbamazepine is perhaps the most widely used antiepileptic drug. Probably, all other drugs account for a smaller volume of sales than carbamazepine alone.

And this is because its pharmacological action is not only anticonvulsant, but also analgesic. It is very good at relieving a special kind of pain, neuropathic pain. This pain develops according to a mechanism similar to a burst of neuronal activity during an epileptic seizure. This pain occurs after herpetic neuralgia, with trigeminal neuralgia, and is characterized by a very fast, paroxysmal course, the attack is similar to an electric shock, has an unpleasant, burning tint.

In addition, carbamazepine is used in psychiatry as a mood stabilizer and antimanic drug. Carbamazepine acts by blocking sodium channels and thereby inhibits the action potential of neurons. This leads to an increase in the reduced seizure threshold, and reduces the risk of developing an attack. Carbamazepine is indicated for simple, partial seizures, as well as for generalized conditions, which are called a large tonic-clonic convulsive seizure.

If it is used in children, then it well reduces depression and anxiety, reduces the potential for irritability and aggression. Carbamazepine is also prescribed in the treatment of chronic alcoholism, for the relief of alcohol withdrawal syndrome, symptoms such as irritability and tremor.

There is also carbamazepine in a prolonged form, which acts for a longer time, such as Finlepsin Retard. The merit of this form is that the concentration of the substance in the blood plasma is more constant and stable, and less prone to jumps. This improves the anticonvulsant effect. The introduction of a prolonged form has led to the possibility of using Carbamazepine only once a day.

Carbamazepine is annually included in the list of essential drugs (Essential Drugs) and is inexpensive. So, Finlepsin at a dosage of 200 mg No. 50 costs from 200 to 270 rubles, and the domestic INN generic Carbamazepine produced by Obolenskoye can even be purchased for 60 rubles. Of course, there is a suspicion that it will not work as well as well-known brands.

Advantages and disadvantages

The advantage of Carbamazepine can be considered the breadth of action, it is used in various forms of epilepsy, and not only in it. It is cheap, prescribed without any problems for a long period, but has some limitations. It cannot be used for severe anemia and a decrease in leukocytes in the blood, for cardiac arrhythmias (atrioventricular blockade), in case of hypersensitivity to tricyclic antidepressants, of which it is a representative.

Care must be taken in heart failure, and especially in combination with chronic alcoholism, in case of increased secretion of antidiuretic hormone and insufficiency of the adrenal cortex, as well as in glaucoma. Especially it is necessary to carefully monitor pregnant women who should use carbamazepine in minimal dosages. Also, the disadvantage is the need to take the drug quite often (except for the retarded form), up to three times a day. Against the background of Carbamazepine, various side effects develop, most often drowsiness, dizziness, decreased appetite and other disorders. Therefore, the patient after the start of treatment must be observed by a doctor. There are also symptoms of overdose, and special cases of interaction with other drugs, but they are all known and well studied.

Valproic acid (Depakine-chrono, Convulex)

This first-generation drug is widely known in our country under the name Depakine-chrono, which is produced by Sanofi, or Konvuleks, by the Austrian company Valeant. This drug is two or even three times more expensive than Carbamazepine. Depakine 500 mg No. 30 costs from 220 to 650 rubles, and Konvuleks has about the same cost.

The active substance of Konvuleks is valproic acid, so experts call these drugs valproates - soluble salts of this acid. They are used in hospitals and outpatients, are available in tablets, syrup, and even in ampoules for intravenous use.

The drug, in addition to the anticonvulsant effect, relaxes the muscles, acting as a central muscle relaxant (Mydocalm, Sirdalud), and produces a sedative effect. It enhances the concentration of the inhibitory mediator, gamma-aminobutyric acid, because it blocks the work of the enzyme that destroys this mediator.

Valproic acid is indicated for quite severe disorders, such as status epilepticus, when it is administered intravenously. Also, drugs are used for large, or generalized seizures in adults and children, which can proceed differently. Convulex also treats specific syndromes that cause severe epilepsy in children, such as Lennox-Gastaut or West syndrome. The drug is used to treat febrile childhood seizures, as well as to treat manic-depressive psychosis in psychiatry, which is now called bipolar affective disorder. The drug should be used in those dosages and according to the scheme prescribed by the doctor, any self-medication is excluded.

Advantages and disadvantages

The drug is available in a variety of dosage forms, and can be used in pediatrics, and in psychiatric practice, and in the relief of emergency conditions. The advantage of valproates is that the drug is effective in all forms of seizures and in all types of epilepsy, so you can start treatment of any form of epilepsy with it, and valproic acid will be the drug of choice, or first line.

The drug is available, it still has a not very high price, but it has a number of contraindications. First of all, these are severe disorders of the liver and pancreas, hepatitis and pancreatitis, a decrease in platelets in the blood plasma, as well as pregnancy and breastfeeding. With great care, valproates are prescribed to children, and especially under the age of three, and also if the child is taking several antiepileptic drugs at once. The combination of agents is always less predictable than monotherapy.

The advantage of Konvuleks and Depakine can be considered quite good tolerance, and a low number of side effects that depend on the dose. If there are adverse reactions, then it is most often nausea, a feeling of fatigue, flies before the eyes, anemia, or changes in body weight, both upward and downward. In the analyzes of the patient, the level of bilirubin, the concentration of hepatic transaminases and nitrogen may increase.

It should not be combined in one patient with the simultaneous administration of valproates and carbamazepine, since Convulex together with carbamazepine contributes to an easier overdose of the latter. Do not combine Konvuleks with phenobarbital, antipsychotics, antidepressants and some antibiotics from the carbapenem group.

It is strictly forbidden to take alcohol during treatment with valproate, as, indeed, in the case of other drugs, because taking ethyl alcohol facilitates the onset of epileptic seizures. The combination of taking ethanol and valproate leads to an increased toxic effect on the liver.

Ethosuximide (Suxilep)

This drug from the group of first-generation antiepileptic drugs can certainly be considered the most expensive. A bottle of capsules, however, in the amount of 100 pieces, will cost about 3,000 rubles, it is not common in pharmacies, and may even be in short supply. If we talk about the average, optimal daily dose, then this is 15 mg per kg of body weight in adults. Therefore, a person who will weigh 80 kg will need 5 such tablets per day, which means that the package for 3,000 rubles will end after 20 days of admission. The cost of a monthly course will be approximately 4500 rubles.

Why is Suxilep used? First of all, for the treatment of small epileptic seizures. His niche is special petit mal seizures with a myoclonic component, impulsive juvenile petit mal seizures, and special forms of absences. Such a “narrow specialization” allowed Suxilep to be a leader in a “narrow niche”, in demand, despite its relatively high cost. As in any other case, the antiepileptic drug Suxilep is started with a dose titration, gradually increasing it by one tablet every 5 days until the seizures decrease or disappear altogether. You can increase the drug, but only to the limit - up to a dosage of no more than 6 tablets per day.

Advantages and disadvantages

Suxilep is usually well tolerated, and contraindications include severe dysfunction of internal organs: the liver and kidneys. The drug is contraindicated in pregnant and lactating women, and the side effects of this drug are about the same as those of carbamazepine. Naturally, the biggest disadvantage of the drug is its high price and it is not always available in pharmacies. But still, given its unique action on special forms of epilepsy, one has to put up with these shortcomings - after all, there are no competitors yet. The drug is produced only imported: by the French company Delpharm Lille, or by German companies - Jena Pharm, and Mibe Artsneimittel.

Phenobarbital is a really cheap drug and should have started a review of seizure medications. One pack of 10 tablets of 100 mg each sells for only 23 rubles. The Federal Enterprise, the Moscow Endocrine Plant, has practically a monopoly on the production of phenobarbital. In addition to this dosage, it is available in tablets of 50 mg, and 5 mg.

The official instruction for phenobarbital says that it is not only an antiepileptic, but also a sleeping pill. Like all barbiturates, it interacts with the special structure of gamma-aminobutyric acid, and reduces the excitability of neuronal cell membranes. Phenobarbital causes drowsiness, hypnotic effect and sedation in high doses. That is why it is part of Corvalol.

Phenobarbital has another important property that is not related to epilepsy. It treats jaundice, but only that jaundice that is associated with hemolytic disease of the newborn, and is not a consequence of viral and alcoholic hepatitis, cirrhosis of the liver. In addition to epilepsy and convulsive syndrome in newborns, the drug is indicated for spastic paralysis, agitation, sleep disorders, if special, expensive modern drugs are not available.

It is for this, for "plugging holes", that Corvalol is produced. If we count the amount of Corvalol, which is sold annually in Russia, then phenobarbital, even purely by weight, will be the most commonly used anticonvulsant drug used for other indications. Take phenobarbital with caution, and only on the recommendation of a specialist! Few people know about this, but only 2 g of phenobarbital, taken orally, can cause death, and ingestion of 1 g causes serious poisoning. This means that half a glass of Corvalol, or 100 ml, drunk, for example, for the purpose of intoxication, contains 1.82 g of phenobarbital, and after such a “dose” you may not wake up.

Advantages and disadvantages

About phenobarbital, or you can say the proverb: "the old horse will not spoil the furrow." This remedy has been an effective anticonvulsant drug for many years, and even decades, but its long-term use has turned out to cause significant disturbances in mental functions, leading to a decrease in intelligence and memory depression. Patients who were on monotherapy with phenobarbital for a long time developed quite serious psychoses, especially in childhood.

At the same time, the range of action of phenobarbital on various forms of epilepsy is not as wide as that of carbamazepine or valproic acid. For example, if we are talking about absence epilepsy, then, on the contrary, it aggravates the course of this form of the disease, and even sometimes provokes seizures. Therefore, at present, phenobarbital, despite its prevalence and low cost, is considered the best drug of first choice only when it comes to convulsive seizures in newborns.

Second generation seizure remedies

Since the early 1990s, second-generation anticonvulsants have entered clinical practice. These are now well-known drugs such as Neurontin and Lamictal, Keppra and Trileptal, Lyrica and Topamax. other means.

Compared to first-generation drugs, their main difference is a targeted search, not a random discovery, and a much smaller number of side effects. The drugs of the first generation quite often affected various enzyme systems, and inhibited or increased their activity. This caused unwanted bursts of hormonal levels, provoked cognitive disorders. Therefore, in the treatment of epilepsy by means of the second generation, there is more simplicity in the schemes, and the adherence of patients to treatment is much higher. Of course, the cost of these drugs is higher.

Given that patients with, for example, generalized epilepsy may experience personality changes, such compliance or adherence is absolutely essential to success. In general, their main difference is greater safety and better portability. In order not to list or repeat, here are the most common common side effects for gabapentin, topamax and lamotrigine. Most often, of course, there was dizziness, and then - transient diplopia, or double vision. Speech disorders have occurred on Topamax, but drowsiness has always remained the most frequent. Consider the most typical and popular representatives of the second generation of a remedy for the treatment of seizures.

Perhaps Lamotrigine is the best-known second-generation drug among epileptologists, and it is a folic acid antagonist and a fairly good sodium channel blocker. Its role is to suppress the release of neurotransmitters that excite neurons into the synaptic cleft. It is rapidly absorbed when taken orally, and lives long enough in the body, its half-life is more than 30 hours. Therefore, Lamotrigine can be taken in the morning, once a day.

Lamotrigine is indicated for use in persons over 12 years of age for the treatment of various forms of epilepsy, the listing of which does not give anything to a person without a medical education. For example, it is a combination therapy for refractory partial epilepsy, as well as Lennox-Gastaut syndrome in children. But it can also be used to treat large convulsive seizures, that is, generalized epilepsy. Importantly, the International Antiepileptic League named it the drug of choice for the elderly with a high level of evidence for the treatment of partial forms.

The average daily dose of lamotrigine, for example, in combination with carbamazepine, is 400 mg. It is also used to treat parkinsonism and reduce the risk of depression in bipolar disorder.

The original drug Lamictal, which is produced by GlaxoSmithkline from the UK, will cost, on average, 2000 rubles. per package (100mg #30 capsules) and this package can last for a week. Accordingly, a monthly course of treatment with the original drug will cost 8,000 rubles. per month. This is very, very expensive for a Russian. The drug Lamolep company Gedeon Richter will cost 1400 rubles. in the same dosage, and the monthly course will cost 5500, but this is also a high cost. The cheapest analogue is Lamotrigine, an INN generic from Canonpharma, and its cost is about 600 rubles. for packing.

Advantages and disadvantages

Of the side effects of Lamotrigine, the most common, and, alas, unpleasant and dangerous, are skin rashes, or exanthema. Quite rarely, it manifests itself as a severe syndrome - Stevens-Johnson or Lyell, when the skin exfoliates, and this condition is life-threatening, and is characterized by high mortality. If only the patient has the slightest hint of a change in the skin while taking Lamotrigine, then the drug is urgently canceled, since in most cases the rash is persistent and irreversible. This is of course a very serious side effect, but, fortunately, very rare. This development can be avoided if the dose is increased very slowly when selecting the desired concentration.

Another "side effect" can be called vitiligo, drowsiness and nausea, a decrease in platelets in the blood plasma, leukopenia and an increase in hepatic transaminases. But in terms of side effects in the population, Lamotrigine is fairly well tolerated. In patients, in addition to the antiepileptic effect, the mood improves, it exhibits an antidepressant effect and improves attention. Including Lamotrigine treats epilepsy well in the elderly, and especially in the presence of depression.

The original Topamax, which is produced by Janssen Сilag from Switzerland, costs from 1100 to 1300 rubles per package (60 capsules of 50 mg). The domestic analogue can be bought at a price of about 190 rubles, but keep in mind that the concentration is half as much, 25 mg, and the number of capsules is also half as much (30 pcs.). Therefore, it is necessary to immediately multiply by four in order for the comparison to be fair. And then the equivalent amount of topiramate produced in Russia will cost about 800 rubles. Therefore, it is better to hold out a little and purchase the original Swiss drug.

Topamax reduces the frequency of the action potential, and works with gamma-aminobutyric acid, blocking sodium channels. It is indicated for treatment strictly older than two years of age, both for newly diagnosed epilepsy, and as part of complex treatment, along with other drugs. It is important that Topamax can be used to prevent migraine attacks, and is used only in the period between attacks.

Topamax should be used by opening the capsules and mixing them with any soft food, swallowing immediately and without chewing. It can be swallowed whole, but the preliminary dispersal of the agent causes a faster and more uniform absorption. The average daily dose, which must be carefully selected together with the doctor, is approximately 300 mg. This means that the original remedy will last for 10 days, and the cost of a monthly course of treatment will be approximately 3,300 rubles.

Advantages and disadvantages

Topiramate is well tolerated with no withdrawal symptoms if abrupt withdrawal of this agent is required. Most often, patients experienced a decrease in body weight, which depends on the dose. In the presence of obesity, this is a very positive, but, alas, not an obligatory side effect. However, there was something else. The concentration of attention decreased, dizziness, drowsiness, and weakness appeared. This means that during treatment with Topamax it is better not to drive. Of course, this applies to persons with migraines, since patients with epilepsy are prohibited from driving. In addition, topiramate is contraindicated in pregnant and lactating women, and in patients with urolithiasis, since the drug can lead to the formation of calcium or phosphate stones - it alkalizes the urine. Women taking hormonal contraceptives while taking Topamax should be especially observed. The effectiveness of contraceptives can be significantly reduced.

Levetiracetam (Keppra, Komviron, Levetinol, Epiterra, Epitropil)

For the first time, Keppra was produced by the Croatian company Pliva. Now it is produced by the Belgian company UCB-Pharma, and in Russia the drug is produced in the form of levetiracetam by Ozon and R-pharm. One package of Keppra tablets in the amount of 30 pieces will cost about 800 rubles, 250 mg each. The domestic drug will cost more than half as much; levetiracetam from Ozon can be bought in September 2019 for 315 rubles.

This drug remains largely a mystery because the antiepileptic mechanism of levetiracetam is still unclear. However, it is used both for partial seizures and for primary generalized, grand mal seizures in adults and children over 12 years of age. Partial seizures may or may not have secondary generalization, but levetiracetam will be quite effective. It is applied twice a day, and a dose of one tablet twice a day is started. This is the stage of getting used to the drug and assessing its tolerance. After 2 weeks, the dose is doubled to 1 g per day. Usually, the therapeutic effect begins at this dosage, and if necessary, it can be increased, but not more than twice, up to 3 g per day. In addition to such monotherapy, there may be complex therapy, when, in addition to levetiracetam, some other drug is prescribed, then the calculation is made based on the dosage per kilogram of body weight.

Advantages and disadvantages

Keppra and quality levetiracetam are well tolerated and significantly improve the quality of life of patients. Of the side effects, drowsiness is most common, and the higher, the more pronounced it is. In second place - weight loss, diarrhea, double vision. Of course, people who develop drowsiness do not want to drive, but a patient diagnosed with epilepsy cannot get a license, so this condition is not very relevant. Also, patients with such a diagnosis are prohibited from working in dangerous working conditions, with moving machines and mechanisms, this must also be taken into account. After all, not always a patient with a newly diagnosed convulsive syndrome can immediately be removed by the labor protection department, or transferred to a non-hazardous job. Do not use levetiracetam in tablets for children under four years old, and in solution - up to 1 month. Carefully it is prescribed to the elderly, and to persons with severe liver damage. In extreme cases, the drug can be used in pregnant women and during breastfeeding, but this should be decided by the council.

Unlike 2nd generation antiepileptic drugs, gabapentin has gained triumphant fame beyond the treatment of epilepsy, and in another area is the treatment of neuropathic pain, and is more effective than the prescription of carbamazepine. It is known as a drug that significantly improves the quality of life in chronic, burning, and carbamazepine-intractable pain. Gabapentin works for conditions such as trigeminal neuralgia, a post-shingles condition called postherpetic neuralgia.

The most expensive drug is the original drug Neurontin, Pfizer. One pack of 300 mg capsules in the amount of 50 pieces will cost an average of 1000 rubles. Gedeon Richter's Tebantine will cost about the same. The maximum cost of Konvalis (domestic company Pharmstandard - 700 rubles), and Belupo's Catena costs from 350 to 680 rubles.

It would seem that this is a low cost, but, unlike other drugs, the selection of gabapentin therapy and dose increase can have quite large limits.

Gabapentin works a little differently than a simple sodium channel blocker. It does not at all affect either the capture or the metabolism of GABA - this inhibitory mediator. It is believed that it affects in general, not the sodium, but the calcium channel. Importantly, it does not interfere with the metabolism of dopamine, serotonin, and norepinephrine, and does not have the side effects of SSRIs, which are commonly used antidepressants.

The drug is indicated primarily for the treatment of neuropathic pain, and as an anticonvulsant - for the treatment of partial seizures with and without secondary generalization in children over 12 years of age and in adults. It is also used as an additional drug in complex therapy for the treatment of partial seizures.

It was said above that Neurontin and its analogues are sold in capsules of 300 mg, and you need to start one capsule 3 times a day. The maximum dosage is 4 times more, that is, 3600 mg per day. But doctors note that dosages above 1800 mg per day are unlikely to give a positive effect, usually pain reduction or anticonvulsant activity works up to this dose, that is, up to a dosage of 2 capsules 3 times a day.

You should not be afraid that the drug will be poorly tolerated, it is well tolerated in doses of almost 5 g per day. It is estimated that one package of Neurontin is enough for about 3 days with an average dose calculation. Then the monthly course will cost 10,000 rubles. And given its long-term use for the treatment of neuropathic pain, this pharmacoeconomic aspect is a well-known problem.

Advantages and disadvantages

The great advantage of gabapentin is its really proven effectiveness, reducing burning and unpleasant pains that torment people at night, and even causing suicide. The inconvenience can be considered a frequent intake - three times a day, the need to count the number of capsules to achieve the desired effect. On the other hand, gabapentin is very well tolerated by almost everyone, and the most common side effects are constipation, shortness of breath, and blurred vision. Effects are dose dependent, and at high doses drowsiness and incoordination may also occur.

It should be remembered that it should not be used in children under 12 years of age as the main drug for the treatment of partial seizures. During pregnancy and lactation, it can be used, but again - by agreement of experts, if the benefit to the mother outweighs the potential risk to the fetus. Because this drug is secreted into breast milk and the effect or lack thereof on the infant is unclear, breastfeeding while receiving gabapentin is necessary given this risk.

What's next?

Today, the 21st century has changed its second decade. Pharmaceutical preparations of the 3rd generation are already ready, for example Briviak. However, their purpose is still inferior to the drugs of the first and second generation, since even their potential is not yet clear to the end, and even second-generation drugs can be safely used for several decades to treat epilepsy.

On the other hand, co-administration regimens are constantly improving, new opportunities are opening up, I and combinations of drugs. Some experts believe that existing drugs are sufficient. A much greater effect will be achieved by observing the following principles of treatment as best as possible:

start treating epilepsy as early as possible, which means that it is necessary to diagnose it in a timely manner as accurately as possible;
you need to pick up a medicine as a monopreparation. This, that is, treatment with a single remedy, is much more desirable than a combination of two or even three antiepileptics;
rationally control the dose, and reduce it to an acceptable level when the effects will exceed minor side effects.

In addition, non-drug treatments for this ancient but well-known disease are constantly being improved. Therefore, in the event that you or your relatives experience incomprehensible seizures, it is urgent to contact a neurologist. It is very important to remember that epilepsy is not always convulsions. They can be regarded as a fall, incomprehensible fainting, seizures similar to hysterical ones, as well as simply an incomprehensible state of stupor and freezing in one position. Sometimes there are outpatients automatically. Well, if this pressing is not a computer key. But sometimes you can continue to cut your own fingers instead of onions. Only after electroencephalography with provocation, and possibly several times, after a thorough examination by a neurologist - epileptologist, can a diagnosis be made and treatment prescribed.

Attention! This rating is subjective, is not an advertisement and does not serve as a purchase guide. Before buying, you need to consult with a specialist.

Antiepileptic drugs prevent and reduce the frequency and intensity of seizures and their equivalents in epilepsy. Epilepsy affects 0.5-1% of the adult population and 1-2% of children.

The pathogenesis of epilepsy is due to the functioning of the epileptogenic focus in the brain. It is formed by neurons (8-10 cells are enough) with pathologically altered membranes that have increased permeability to sodium and calcium ions. These neurons are capable of spontaneous depolarization and generate hypersynchronous impulses that excite healthy areas of the brain. Most often, the epileptogenic focus is localized in structures with a low threshold of excitation - the cerebral cortex, the hippocampus, the amygdala, the thalamus, and the reticular formation of the midbrain. He rarely appears in

Forms of epilepsy		Antiepileptic drugs*
Generalized seizures
Tonic-clonic	Loss of consciousness, aura (sensory, motor, vegetative,	Carbamazepine
seizure	mental, depending on the location of the epileptogenic focus),
(big fit,	tonic convulsions with respiratory arrest, clonic convulsions;	Valproates
grand mal)	duration - 1-2 minutes	Phenobarbital
		Lamotrigine
		Hexamidine
Epileptic	Recurrent tonic-clonic seizures when the patient is between.
	seizures does not come to consciousness, often ends	Lorazepam
	death from paralysis of the respiratory center, pulmonary edema,	Clonazepam
	hyperthermia. acute heart failure	Phenobarbital sodium
		Diphenin sodium
		Means for anesthesia
Absence (small	Sudden loss of consciousness, sometimes with short duration	Ethosuximide
seizure)	convulsions (nods, pecks); duration - about 30 seconds	Clonazepam
		Valproates
		Lamotrigine
Myoclonus-	Short-term (sometimes within 1 second) sudden	Valproates
epilepsy	muscle contractions of one limb or generalized	Clonazepam
	muscle contractions without loss of consciousness

Forms of epilepsy		Antiepileptic drugs
Partial seizures
Simple seizures	Various symptoms depending on the location of the epileptogenic	Carbamazepine
	focus, for example, with convulsive activity in the motor cortex - clone
	muscle twitching, with excitation of the somatosensory cortex	Phenobarbital
	paresthesia; consciousness is preserved; duration - 20-60 seconds	Hexamidine
		Valproates
		Gabapentin
		Lamotrigine
Psychomotor	Twilight consciousness with automatisms and unconscious, unmotivated	Carbamazepine
seizures	by deeds that the patient does not remember
		Valproates
		Phenobarbital
		Hexamidine
		Clonazepam
		Gabapentin
		Lamotrigine

Note: * - agents are listed in order of decreasing therapeutic efficacy.

striatum, cerebellum and pontine reticular formation, where the GABAergic inhibition system functions well.

There are generalized and partial (focal) forms of epilepsy.

Generalized tonic-clonic epileptic seizures occur as a result of frequent action potentials caused by the entry of sodium ions into neurons. During the resting potential, sodium channels are closed (external activation and intracellular inactivation gates are closed); when depolarized, the channels open (both types of gates are open); during the period of repolarization, sodium channels are in an inactivated state (activation gates are open, inactivation gates are closed).

Antiepileptic drugs that have a therapeutic effect in tonic-clonic seizures (difenin, carbamazepine, valproate, lamotrigine) prolong the inactivated state of sodium channels and slow down repolarization. This delays the onset of the next action potential and leads to a more rare generation of discharges in neurons.

In absence seizures, the focus of convulsive activity is localized in the thalamus. Thalamic neurons generate action potentials at a frequency of 3 per 1 second as a result of the entry of calcium ions through G-type channels (eng. transient- transitory, short-lived). Thalamic impulses excite the cerebral cortex. Calcium ions, having a neurotoxic (excitotoxic) effect, create the danger of a progressive mental disorder.

Drugs that are effective in absence seizures (ethosuximide, valproate) block T-channels, suppress calcium-type action potentials in the thalamus. eliminate their stimulating effect on the cortex. have a neuroprotective effect.

In epilepsy, the function of inhibitory GABAergic synapses is impaired, the function of synapses that release excitatory amino acids, glutamine and aspartic, increases. A decrease in the work of inhibitory synapses by only 20% is accompanied by the development of convulsive seizures.

Phenobarbital, benzonal, hexamidine and clonazepam potentiate GABAergic inhibition caused by GABAd receptors. These receptors, opening the chloride channels of neurons, increase the entry of chloride ions, which is accompanied by hyperpolarization.

Valproates activate the enzyme that catalyzes the formation of GABA from glutamic acid, glutamate decarboxylase, and also inhibit the GABA inactivation enzyme, GABA transaminase. Vigabatrin irreversibly blocks GABA transaminase. Gabapentin triples the release of GABA from presynaptic terminals. As a result, valproate, vigabatrin and gabapentin cause a significant accumulation of GABA in the brain. Lamotrigine, blocking the sodium channels of the presynaptic membrane, reduces the release of glutamine and aspartic amino acids.

Antiepileptic drugs suppress energy production in the epileptogenic focus, reduce the content of folic acid, which is necessary for the development of a seizure. Difenin and phenobarbital, by inhibiting the intestinal enzyme folate deconjugate, disrupt the absorption of folic acid; accelerate the inactivation of folic acid in the liver.

Thus, the therapeutic effect of antiepileptic drugs is pathogenetic in nature.

In the 19th century, bromides in high doses were the main means of treating epilepsy. In 1912, phenobarbital was used to treat epilepsy. Its hypnotic effect prompted the search for a drug with a selective anticonvulsant effect. Difenin, discovered in 1938 during the screening of many compounds in a model of tonic-clonic epileptic seizure (maximum electric shock), became such a drug. Until 1965, trimetin and ethosuximide, the treatment of absences, entered medical practice; after 1965, carbamazepine, valproates, lamotrigine, and gabapentin were created.

With epilepsy, the psyche of patients suffers (epileptic character). There are concreteness of thinking, mental viscosity, excessive pedantry, affective explosiveness, touchiness, pettiness, stubbornness, epileptic dementia. Mental disorders are caused by the degeneration of neurons. having receptors for excitatory amino acids. Frequent absence seizures and myoclonus epilepsy lead to early dementia. Many antiepileptic drugs improve the psyche of patients.

Let's start with the description of the group antiepileptic drugs (AEDs).

Antiepileptic drugs able to prevent the development of seizures in patients with epilepsy.

Brief historical background about anticonvulsants.

Since 1853, bromides have been used to treat epileptic seizures. These were ineffective drugs, they were used in large doses and gave pronounced side effects. Since 1912, the use of phenobarbital began, and this is already a more effective remedy, therefore it is also prescribed at the present time, but it has a depressing effect on the central nervous system. Since 1938, its analogues with fewer side effects have been synthesized - phenytoin, benzobarbital, primidone and trimethadione. Later, ethosuximide, carbamazepine, lamotrigine, gabapentin, and others began to be used.

What's happening .

In epilepsy, diffuse or focal spontaneous excitation of brain neurons occurs, and this can lead to seizures. The launch of excitation comes from cells - "pacemakers" - neurons with an unstable resting potential on the membrane. The action of antiepileptic drugs is to stabilize the resting potential of these neurons and reduce the excitability of the epileptogenic focus.

different.

Phenytoin, lamotrigine and phenobarbital inhibit the release of glutamate from the endings of excitatory neurons, preventing the activation of epileptic focus neurons.

Valproic acid is an antagonist of neuronal NMDA receptors and prevents the interaction of glutamate with NMDA receptors, and this reduces excitation in the epileptic focus.

Benzodiazepines and phenobarbital interact with the GABA receptor complex, increase sensitivity to GABA inhibitory mediators and increase the flow of chloride ions into neurons, and this increases their resistance.

Tiagabine blocks the reuptake of GABA from the synaptic cleft, which inhibits neuronal firing. Vigabatrin leads to inhibition of the enzyme that destroys GABA, which increases the amount of inhibitory neurotransmitter in nerve cells.

Gabapentin increases the formation of GABA by slowing down its metabolism, increases the utilization of glutamate, a precursor of GABA, and also opens potassium channels. All this stabilizes the membrane.

Carbamazepine, valproate, and phenytoin limit the propagation of electrical potential by blocking sodium and calcium channels. Ethosuximide blocks T-type calcium channels.

Here is a list of antiepileptic drugs

trade names - 110; Active ingredients - 26.

Active substance		Trade names
Acetazolamide* (Acetazolamide*)		AcetazolamideDiakarb ®
Barbexaclone* (Barbexaclone*)		Maliazin
Beclamide* (Beclamide*)		ChloraconChloracone tablets 250 mg
Benzobarbital* (Benzobarbital*)		benzobarbitalBenzonal Benzonal tablets 0.05 g Benzonal tablets 0.1 g
Valproic acid* (Valproic acid*)		Valparin ® Valparin ® XPsodium valproate Valproic acid Sandoz ® Depakine ® Depakine ® chrono Depakine ® Chronosphere™ Depakine ® Enterik 300 Dipromal Convulex ® Convulsofin ® encorate Encorat chrono
Valpromide* (Valpromide*)		Depamid
Vigabatrin* (Vigabatrin*)		Sabril
Gabapentin* (Gabapentin*)		Gabagamma ® Gabapentin Gapentek ® Catena ® Convalis Lepsitin Neurontin ® Tebantine ® EGIPENTINE Eplirontin
Diazepam* (Diazepam*)		Apaurin Valium Roche diazepa bene Diazepam Diazepam Nycomed Diazepam-ratiopharm diazepex Diapam Relanium ® Relium Seduxen Sibazon Sibazone injection 0.5% Sibazone tablets
Zonisamide* (Zonisamide*)		Zonegran ®
Carbamazepine* (Carbamazepine*)		Actinerval ® Apo-carbamazepine Zagretol Zeptol Carbalepsin retard Carbamazepine Carbamazepine Nycomed Carbamazepine tablets 0.2 g Carbamazepine-Acri ® Carbamazepine-Ferein Karbapin Karbasan retard Mazepin Stazepin Storylat Tegretol ® Tegretol ® CR Finlepsin ® Finlepsin ® retard Epial
Clonazepam* (Clonazepam*)		Clonazepam Clonotril Rivotril
Lacosamide* (Lacosamide*)		Vimpat ®
Lamotrigine* (Lamotrigine*)		Vero-LamotrigineConvulsan Lameptil Lamictal ® Lamitor DT Lamitor ® Lamolep ® Lamotrigine Lamotrix ® Seizar Triginet
Levetiracetam* (Levetiracetam*)		Keppra ®Komviron Levetinol ® Levetiracetam Levetiracetam Canon Epiterra
Oxcarbazepine* (Oxcarbazepine*)		Trileptal ®
Perampanel* (Perampanel*)		Fycompa™
Pregabalin* (Pregabalin*)		AlgericaLyrica ® Pregabalin Pregabalin-Richter
Primidone* (Primidone*)		HexamidineMisolin primidon
Retigabine* (Retigabine*)		Trobalt
Tiagabine* (Tiagabine*)		Gabitril
Topiramate* (Topiramate*)		Maxitopyr ®Topalepsin Topamax ® Topiramate Topiramate-Teva Topiromax Topsaver Toreal ® T orepimat Epimax epitope
Phenytoin* (Phenytoin*)		Difenin
Phenobarbital* (Phenobarbital*)		PhenobarbitalPhenobarbital (Luminal) Phenobarbital tablets for children Phenobarbital tablets Phenobarbital tablets for children 0.005
Eslicarbazepine acetate (Eslicarbazepine acetate)		Exalief ®
Ethosuximide* (Ethosuximide*)		Suxilep

Mechanism of action of antiepileptic drugs not yet fully explored. Scientific research is underway to refine it and synthesize new effective means. It has been proven that the stabilization of neurons is possible by different mechanisms of action and their combinations.

At the present stage in the arsenal of doctors there are many old and new quite effective and safe antiepileptic drugs.

Content

This group of drugs is used to stop or prevent seizures of a different nature. Seizure drugs include a list of medications that are usually used when a person has epilepsy and are called antiepileptic drugs.

The action of anticonvulsants

During an attack, a person experiences not only muscle spasms, but also pain due to them. The action of anticonvulsants is aimed at eliminating these manifestations, stopping the attack so that it does not go from pain to epileptic, convulsive phenomena. A nerve impulse is activated along with a specific group of neurons in the same way as it occurs when transmitted from motor-type neurons from the cerebral cortex.

Anticonvulsant tablets should eliminate pain, muscle spasms without depression of the central nervous system. Such medicines are selected individually, the degree of complexity of the pathology is taken into account. Depending on this, medications can be used for a certain period or for life, if a genetic or chronic form of the disease is diagnosed.

Groups of anticonvulsants

To prevent epileptic seizures, convulsions, doctors have developed various means that have differences in the principle of action. The doctor should prescribe specific anticonvulsants based on the nature of the origin of the seizures. The following groups of anticonvulsants are distinguished:

	Name	Action
Barbiturates and derivatives	Phenobarbital, Benzamyl, Benzoylbarbamyl, Benzonal, Benzobamyl.	They are aimed at inhibition of neurons of the epileptic focus. As a rule, it has an indiscriminate inhibitory effect on the central nervous system.
Benzodiazepines	Rivotril, Clonazepam, Ictorivil, Antelepsin, Ravatril, Klonopin, Ictoril.	These medications turn out the activity of inhibitory neurons by acting on GABA receptors.
Iminostilbenes	Carbamazepine, Zeptol, Finlepsin, Amizepine, Tegretol.	They have a restrictive effect on the propagation of electrical potential through neurons.
Sodium valproate and derivatives	Acediprol, Epilim, Sodium Valproate, Apilepsin, Valparin, Diplexil, Convulex.	They have a sedative, tranquilizing effect, improve the emotional background of the patient.
Succinimides	Ethosuximide, Pufemid, Ronton, Succimal, Etimal, Suxilep, Pycnolepsin, Valparin, Difenin, Xanax, Keppra, Actinerval;	Appointed for the treatment of absences, the tablets are a calcium channel blocker. Eliminate muscle spasms in neuralgia.

Anticonvulsants for epilepsy

Some funds are dispensed without a prescription, some only with it. Any pills for epilepsy should be prescribed only by a doctor in order to avoid side effects and not provoke complications. It is important to go to the hospital in a timely manner, a quick diagnosis will increase the chances of remission, the duration of the medication. Popular anticonvulsants for epilepsy are listed below:

Feniton. Tablets belong to the hydantoin group, used to slightly slow down the reaction of nerve endings. It helps to stabilize neuronal membranes. It is prescribed, as a rule, for patients who suffer from frequent convulsions.
Phenobarbital. Included in the list of barbiturates, it is actively used for therapy in the first stages, to maintain remission. The drug has a calming mild effect, which is not always enough during epilepsy, so it is often prescribed together with other drugs.
Lamotrigine. It is considered one of the most powerful antiepileptic drugs. A properly scheduled course of treatment can stabilize the entire functioning of the nervous system without disturbing the release of amino acids.
Benzobamyl. This drug has low toxicity, mild action, so it can be prescribed to a child who suffers from seizures. The remedy is contraindicated for people with pathologies of the heart, kidneys, liver.
sodium valproate. It is an antiepileptic drug, prescribed for behavioral disorders. It has a number of serious side effects: the appearance of a rash, deterioration in clarity of consciousness, decreased blood clotting, obesity, poor blood circulation.
primidon. It is an antiepileptic drug used in severe epilepsy attacks. The drug has a powerful inhibitory effect on damaged neurons, which helps to stop seizures. You can take this anticonvulsant only after consulting a doctor.

Anticonvulsants for neuralgia

it is recommended to start treatment as early as possible, for this you need to contact a specialist after the first symptoms of the disease. Therapy is based on a whole range of medications to eliminate the causes and signs of nerve damage. Anticonvulsants play a leading role in treatment. They are needed to prevent seizures of epilepsy, convulsions. The following anticonvulsants are used for neuralgia:

Clonazepam. It is a derivative of benzodiazepine, differs in that it has an anxiolytic, anticonvulsant, sedative effect. The mechanism of action of the active substance helps to improve sleep, relax muscles. It is not recommended to use without a doctor's prescription, even according to the instructions.
Carbamazepine. According to the classification, the drug belongs to iminostilbenes. It has a pronounced anticonvulsant, moderate antidepressant effect, normalizes the emotional background. Helps to significantly reduce pain in case of neuralgia. The antiepileptic drug acts quickly, but the course will always be long, because due to the premature withdrawal of the drug, the pain may return.
Phenobarbital. Belongs to the group of barbiturates, which act in the treatment of neuralgia as a sedative, hypnotic drug. This anticonvulsant is prescribed in small doses, it should be taken strictly according to the doctor's prescription, because the side effects of anticonvulsants are contraindicated in a number of other diseases.

Anticonvulsants for children

The choice in this case falls on medications that should significantly reduce the excitability of the central nervous system. Many drugs of this type can be dangerous for the baby because they depress breathing. Anticonvulsants for children are divided into two groups according to the degree of danger to the child:

Drugs that have little effect on breathing: lidocaine, benzodiazepines, hydroxybutyrates, fentanyl, droperidol.
More dangerous substances that have a depressing effect: barbiturates, chloral hydrate, magnesium sulfate.

When choosing a medicine for babies, the features of the pharmacology of the drug are very important, adults are less susceptible to side effects than a child. The list of fixed assets that are used in the treatment of children includes the following medicines:

Droperidol, Fentanyl- have an effective effect on the hippocampus, from which the seizure signal comes, but the composition does not contain morphine, which in infants under 1 year old can cause breathing problems. This problem can be eliminated with the help of nalorphine.
Benzodiazepines- as a rule, sibazon is used, which may have the name diazepam or seduxen. Intravenous administration of the drug stops convulsions within 5 minutes, respiratory depression can be observed with large doses of the drug. The situation can be corrected by the introduction of physostigmine intramuscularly.
Lidocaine. The tool is able to almost immediately suppress any type of convulsions in babies if given an intravenous injection. In therapy, as a rule, a loading dose is first administered, then droppers are used.
Phenobarbital. It is used for prevention and treatment. It is prescribed, as a rule, for weak attacks, because the result from the application develops 4-6 hours. The main plus of the drug is that the action in children can last up to 2 days. Good results are observed when taken simultaneously with sibazon.
Hexenal. A strong drug, but it has a depressant effect on breathing, which greatly limits its use in children.

New generation anticonvulsants

When choosing a medication, the doctor must necessarily take into account the origin of the pathology. Anticonvulsants of the new generation are aimed at solving a wider range of causes, causing a minimum number of side effects. Development is ongoing, so over time, more and more modern tools appear that cannot be bought in an online store or ordered home. Of the modern options, such effective antiepileptic drugs of the new generation are distinguished:

Difenin- indicated for severe seizures, trigeminal neuralgia.
Zarontin (aka Suxilep). A tool that has proven to be highly effective, treatment must be carried out continuously.
Keppra contains the substance Levetiracetam, the mechanism of its effect on the body is not fully understood. Experts suggest that the drug affects the glycine and gamma-aminobutyric acid receptors. A positive effect has been confirmed in the treatment of generalized epileptic seizures and partial seizures with Keppra.
Ospolot- a new generation anticonvulsant, the effect of the active substance has not been fully studied. The use of the drug in partial epileptic seizures is justified. The doctor prescribes a daily dose, which should be divided into 2-3 doses.
Petnidan- the active ingredient is called ethosuximide, highly effective in the treatment of absence seizures. Be sure to coordinate with your doctor.

Side effects of anticonvulsants

Most anticonvulsants are available on prescription and are not available commercially. This is due to the large number and high risk of side effects with an overdose of medications. The doctor can choose the right drug, based on the results of the tests, it is not recommended to buy medicines on your own. The most common side effects of anticonvulsants in violation of the rules of admission are:

uncertainty when walking;
dizziness;
vomiting, drowsiness, nausea;
double vision;
respiratory depression;
allergic reactions (rash, deterioration of hematopoiesis, liver failure).

The price of anticonvulsants

Most medicines can be found in the catalog on pharmacy websites, but for some groups of drugs you will need a doctor's prescription. The cost of medicines may vary depending on the manufacturer, place of sale. The estimated price for anticonvulsants in the Moscow region is as follows.

Epilepsy is a severe chronic disease that requires long-term and serious treatment. Today, several forms of the disease are distinguished, but all of them are united by the main symptom - the presence of epileptic seizures.

Antiepileptic drugs are used to treat the disease, which can prevent the recurrence of seizures, and also help return people with epilepsy to a normal, fulfilling life.

Medical treatment

Any remedy for epilepsy is aimed at maximizing the quality of life of a person who has been diagnosed with this disease.

The medicine for epilepsy is selected by the doctor strictly on an individual basis.

This necessarily takes into account such important factors as the type of epilepsy, the clinical form of the attack, the presence of other chronic diseases, age, height, weight of the patient.

The main goals of therapy:

Prevention of new epileptic seizures.
Maximum pain relief of seizures if they are accompanied by painful cramps.
Reducing the frequency and duration of epileptic seizures.
Reduce side effects and existing risks from drug therapy.

The most commonly used drugs for epilepsy are anticonvulsants, sedatives, and tranquilizers.

At the moment, all medications that are taken to treat epilepsy are divided into "new" and "old".

New generation drugs are distinguished by high efficiency and a minimum list of side effects.

Anticonvulsants

What anticonvulsants for epilepsy are considered the most effective and effective?

The list of the latest medicines for this disease is as follows:

Carbamazepine;
Clonazepam;
Beclamid;
Phenobarbital;
Phenytoin;
Valproate;
Primidon;
Oxcarbazepine;
Lamotrigine;
Topiramate.

If a person has been diagnosed with epilepsy, the drugs listed above help to effectively deal with various types of epilepsy - temporal, cryptogenic, idiopathic, focal.

Any antiepileptic drug from the category of anticonvulsants is aimed at stopping muscle cramps, regardless of the nature of origin, increasing the activity of neurons responsible for the "inhibitory" function, as well as maximum inhibition of excitatory neurons.

All this can significantly reduce the frequency and duration of epileptic seizures.

It should be noted that such drugs for the treatment of epilepsy have a pronounced inhibitory effect on the functioning of the central nervous system, their use can cause a number of side effects:

Headaches and dizziness;
Constant sleepiness;
Motility disorders;
cognitive pathologies;
Memory deterioration.

Anticonvulsant drugs are most often produced in the pharmacological form of tablets - for example, Midazolam, Nitrazepam, Difenin, Depakine, Konvuleks, Konvulsofin, Tegretol, Luminal, Pagluferal.

Depakine, Valproate are popular drugs from the valproate category, which are often used to treat epilepsy. Available in the form of tablets, capsules, granules, syrup.

These drugs can have a negative effect on the liver, so it is imperative to constantly monitor the level of liver enzymes. It can also lead to weight gain, hair loss, drowsiness, trembling limbs.

Carbamazepine, Tegretol - is used to treat partial and secondarily generalized epileptic seizures. The medicine can be used for children older than 12 months. The maximum allowable dose is 10-20 mg per kg of body weight.

With prolonged use of carbamazepine, adverse reactions may occur - dizziness, nausea, vomiting.

Lamotrigine is most effective in generalized tonic-clonic seizures. It has an anticonvulsant effect, improves mood and relieves depression. The initial dosage of the drug is 1-3 mg per kg of body weight per day, it is recommended to gradually increase the dosage.

In some cases, medication is accompanied by sleep disturbances, aggressiveness, tearfulness, skin rashes and other allergic reactions.

Tranquilizers in the treatment of epilepsy

A tranquilizer is a psychotropic type of medication that is used to suppress excessive excitability of the central nervous system and reduce anxiety. The main benefit of using tranquilizers is sedative, anticonvulsant and hypnotic action.

Many people wonder - we drink tranquilizers for epilepsy, how long should the treatment be?

It should be remembered that drugs from the group of tranquilizers should never be drunk for a long period of time.

This can lead to addiction of the body and even to complete physical dependence on the drug. Therefore, the question of taking tranquilizers should be decided exclusively by a doctor.

In some cases, tablets can cause a number of side effects, among which are chronic fatigue, drowsiness, memory impairment, attention and concentration, and the development of a severe depressive state.

Original or generic?

For the effectiveness of epilepsy therapy, it is of great importance what kind of drug is used - a generic or the original of the latest generation?

As it becomes clear from the name, the original is a new generation tool, which was patented by the pharmacological manufacturing company, passed all the necessary laboratory and clinical studies.

In turn, a generic is a so-called analogue, a cheaper drug with a similar active substance, but from a different manufacturer.

It should be noted that the main production technologies and the composition of auxiliary components in a generic can differ significantly from the original.

For the treatment of epilepsy, it is best to use branded, original medications. But many patients ask to replace original medicines with generics - most often this is due to lower cost.

But in this case, it is necessary to adjust the dose of the drug, in most cases it increases.

In addition, when using analogues, the frequency of side effects increases significantly, which also cannot but affect a person's well-being. And therefore, the choice of a medicine against epilepsy rests solely with the attending specialist.

Can epilepsy be permanently cured?

According to medical statistics, the highest chances of a complete cure for epilepsy are in children and adolescents. In this category, the cure rate reaches 80-82%.

Among adult patients, the recovery rate is already 45-50%. In 32% of cases, patients note that the frequency, number and duration of epileptic seizures have decreased significantly.

Unfortunately, in medical practice such a thing as resistant epilepsy stands out - it makes up approximately 20-23% of all cases of the disease and is considered incurable by medication. In this case, only surgery helps.

Surgical treatment is considered the most effective in resistant epilepsy and leads to a cure in 91% of cases.