Antiepileptics & Anticonvulsants

Carbamazepine is an iminostilbene dibenzazepine antiepileptic on the WHO Model List of Essential Medicines. It voltage- and use-dependently blocks neuronal voltage-gated sodium channels, preventing repetitive neuronal firing and inhibiting spread of seizure discharges. It is the gold-standard first-line agent for trigeminal neuralgia. Indicated for focal (partial) seizures, generalized tonic-clonic seizures, trigeminal neuralgia, and acute mania/bipolar maintenance.

Phenytoin is a classic hydantoin antiepileptic on the WHO Model List of Essential Medicines. It voltage- and use-dependently promotes sodium channel inactivation, stabilizing neuronal membranes and limiting the spread of seizure activity from epileptic foci. Exhibits non-linear (Michaelis-Menten) saturation pharmacokinetics, where small dose increases can produce disproportionate, toxic rises in plasma concentrations. Indicated for tonic-clonic (grand mal) seizures, focal seizures, and prevention/treatment of seizures following neurosurgery.

Levetiracetam is a pyrrolidone derivative second-generation antiepileptic on the WHO Model List of Essential Medicines. It exhibits a unique mechanism of action, binding stereoselectively to synaptic vesicle protein 2A (SV2A) in presynaptic terminals, modulating exocytosis and restraining pathological vesicle release of excitatory neurotransmitters without affecting normal neurotransmission. Demonstrates near 100% oral bioavailability and minimal hepatic CYP450 metabolism. Indicated as monotherapy and adjunctive therapy for focal seizures, myoclonic seizures in juvenile myoclonic epilepsy, and primary generalized tonic-clonic seizures.

Lamotrigine is a phenyltriazine antiepileptic and mood stabilizer on the WHO Model List of Essential Medicines. It use- and voltage-dependently blocks voltage-gated sodium channels, suppressing the sustained repetitive firing of neurons and inhibiting the pathological release of the excitatory neurotransmitter glutamate. Indicated for focal seizures, generalized tonic-clonic seizures, Lennox-Gastaut syndrome, and maintenance treatment of bipolar I disorder to delay mood episodes.

Phenobarbitone (Phenobarbital) is a long-acting barbiturate anticonvulsant on the WHO Model List of Essential Medicines. It binds allosterically to GABAA receptors, prolonging the open duration of neuronal chloride ion channels, enhancing GABA-mediated inhibition, and suppressing glutamate-mediated excitation. Indicated for generalized tonic-clonic seizures, focal seizures, and neonatal seizures.

Sodium Valproate / Divalproex Sodium is a broad-spectrum antiepileptic and mood stabilizer on the WHO Model List of Essential Medicines. It increases brain gamma-aminobutyric acid (GABA) levels by inhibiting GABA transaminase and succinic semialdehyde dehydrogenase, while blocking voltage-gated T-type calcium channels and sustained repetitive firing of voltage-sensitive sodium channels. Indicated for generalized and focal epilepsy (absence, myoclonic, tonic-clonic seizures), acute manic episodes in bipolar disorder, and migraine prophylaxis.

Sodium Valproate / Divalproex Sodium is a broad-spectrum antiepileptic and mood stabilizer on the WHO Model List of Essential Medicines. It increases brain gamma-aminobutyric acid (GABA) levels by inhibiting GABA transaminase and succinic semialdehyde dehydrogenase, while blocking voltage-gated T-type calcium channels and sustained repetitive firing of voltage-sensitive sodium channels. Indicated for generalized and focal epilepsy (absence, myoclonic, tonic-clonic seizures), acute manic episodes in bipolar disorder, and migraine prophylaxis.

Clobazam is a 1,5-benzodiazepine with preferential affinity for the alpha-2 subunit of GABAA receptors over alpha-1, conferring potent anticonvulsant and anxiolytic efficacy with reduced sedative and motor impairment compared to traditional 1,4-benzodiazepines. Its active metabolite, N-desmethylclobazam, provides prolonged neuronal stabilization. Indicated as adjunctive therapy for refractory epilepsy, Lennox-Gastaut syndrome, and severe anxiety.

Carbamazepine is an iminostilbene dibenzazepine antiepileptic on the WHO Model List of Essential Medicines. It voltage- and use-dependently blocks neuronal voltage-gated sodium channels, preventing repetitive neuronal firing and inhibiting spread of seizure discharges. It is the gold-standard first-line agent for trigeminal neuralgia. Indicated for focal (partial) seizures, generalized tonic-clonic seizures, trigeminal neuralgia, and acute mania/bipolar maintenance.

Phenobarbitone (Phenobarbital) is a long-acting barbiturate anticonvulsant on the WHO Model List of Essential Medicines. It binds allosterically to GABAA receptors, prolonging the open duration of neuronal chloride ion channels, enhancing GABA-mediated inhibition, and suppressing glutamate-mediated excitation. Indicated for generalized tonic-clonic seizures, focal seizures, and neonatal seizures.

Lamotrigine is a phenyltriazine antiepileptic and mood stabilizer on the WHO Model List of Essential Medicines. It use- and voltage-dependently blocks voltage-gated sodium channels, suppressing the sustained repetitive firing of neurons and inhibiting the pathological release of the excitatory neurotransmitter glutamate. Indicated for focal seizures, generalized tonic-clonic seizures, Lennox-Gastaut syndrome, and maintenance treatment of bipolar I disorder to delay mood episodes.

Levetiracetam is a pyrrolidone derivative second-generation antiepileptic on the WHO Model List of Essential Medicines. It exhibits a unique mechanism of action, binding stereoselectively to synaptic vesicle protein 2A (SV2A) in presynaptic terminals, modulating exocytosis and restraining pathological vesicle release of excitatory neurotransmitters without affecting normal neurotransmission. Demonstrates near 100% oral bioavailability and minimal hepatic CYP450 metabolism. Indicated as monotherapy and adjunctive therapy for focal seizures, myoclonic seizures in juvenile myoclonic epilepsy, and primary generalized tonic-clonic seizures.

Clobazam is a 1,5-benzodiazepine with preferential affinity for the alpha-2 subunit of GABAA receptors over alpha-1, conferring potent anticonvulsant and anxiolytic efficacy with reduced sedative and motor impairment compared to traditional 1,4-benzodiazepines. Its active metabolite, N-desmethylclobazam, provides prolonged neuronal stabilization. Indicated as adjunctive therapy for refractory epilepsy, Lennox-Gastaut syndrome, and severe anxiety.

Sodium Valproate / Divalproex Sodium is a broad-spectrum antiepileptic and mood stabilizer on the WHO Model List of Essential Medicines. It increases brain gamma-aminobutyric acid (GABA) levels by inhibiting GABA transaminase and succinic semialdehyde dehydrogenase, while blocking voltage-gated T-type calcium channels and sustained repetitive firing of voltage-sensitive sodium channels. Indicated for generalized and focal epilepsy (absence, myoclonic, tonic-clonic seizures), acute manic episodes in bipolar disorder, and migraine prophylaxis.

Levetiracetam is a pyrrolidone derivative second-generation antiepileptic on the WHO Model List of Essential Medicines. It exhibits a unique mechanism of action, binding stereoselectively to synaptic vesicle protein 2A (SV2A) in presynaptic terminals, modulating exocytosis and restraining pathological vesicle release of excitatory neurotransmitters without affecting normal neurotransmission. Demonstrates near 100% oral bioavailability and minimal hepatic CYP450 metabolism. Indicated as monotherapy and adjunctive therapy for focal seizures, myoclonic seizures in juvenile myoclonic epilepsy, and primary generalized tonic-clonic seizures.

Levetiracetam is a pyrrolidone derivative second-generation antiepileptic on the WHO Model List of Essential Medicines. It exhibits a unique mechanism of action, binding stereoselectively to synaptic vesicle protein 2A (SV2A) in presynaptic terminals, modulating exocytosis and restraining pathological vesicle release of excitatory neurotransmitters without affecting normal neurotransmission. Demonstrates near 100% oral bioavailability and minimal hepatic CYP450 metabolism. Indicated as monotherapy and adjunctive therapy for focal seizures, myoclonic seizures in juvenile myoclonic epilepsy, and primary generalized tonic-clonic seizures.

Levetiracetam is a pyrrolidone derivative second-generation antiepileptic on the WHO Model List of Essential Medicines. It exhibits a unique mechanism of action, binding stereoselectively to synaptic vesicle protein 2A (SV2A) in presynaptic terminals, modulating exocytosis and restraining pathological vesicle release of excitatory neurotransmitters without affecting normal neurotransmission. Demonstrates near 100% oral bioavailability and minimal hepatic CYP450 metabolism. Indicated as monotherapy and adjunctive therapy for focal seizures, myoclonic seizures in juvenile myoclonic epilepsy, and primary generalized tonic-clonic seizures.

Sodium Valproate / Divalproex Sodium is a broad-spectrum antiepileptic and mood stabilizer on the WHO Model List of Essential Medicines. It increases brain gamma-aminobutyric acid (GABA) levels by inhibiting GABA transaminase and succinic semialdehyde dehydrogenase, while blocking voltage-gated T-type calcium channels and sustained repetitive firing of voltage-sensitive sodium channels. Indicated for generalized and focal epilepsy (absence, myoclonic, tonic-clonic seizures), acute manic episodes in bipolar disorder, and migraine prophylaxis.

Sodium Valproate / Divalproex Sodium is a broad-spectrum antiepileptic and mood stabilizer on the WHO Model List of Essential Medicines. It increases brain gamma-aminobutyric acid (GABA) levels by inhibiting GABA transaminase and succinic semialdehyde dehydrogenase, while blocking voltage-gated T-type calcium channels and sustained repetitive firing of voltage-sensitive sodium channels. Indicated for generalized and focal epilepsy (absence, myoclonic, tonic-clonic seizures), acute manic episodes in bipolar disorder, and migraine prophylaxis.

Sodium Valproate / Divalproex Sodium is a broad-spectrum antiepileptic and mood stabilizer on the WHO Model List of Essential Medicines. It increases brain gamma-aminobutyric acid (GABA) levels by inhibiting GABA transaminase and succinic semialdehyde dehydrogenase, while blocking voltage-gated T-type calcium channels and sustained repetitive firing of voltage-sensitive sodium channels. Indicated for generalized and focal epilepsy (absence, myoclonic, tonic-clonic seizures), acute manic episodes in bipolar disorder, and migraine prophylaxis.

Lamotrigine is a phenyltriazine antiepileptic and mood stabilizer on the WHO Model List of Essential Medicines. It use- and voltage-dependently blocks voltage-gated sodium channels, suppressing the sustained repetitive firing of neurons and inhibiting the pathological release of the excitatory neurotransmitter glutamate. Indicated for focal seizures, generalized tonic-clonic seizures, Lennox-Gastaut syndrome, and maintenance treatment of bipolar I disorder to delay mood episodes.

Lamotrigine is a phenyltriazine antiepileptic and mood stabilizer on the WHO Model List of Essential Medicines. It use- and voltage-dependently blocks voltage-gated sodium channels, suppressing the sustained repetitive firing of neurons and inhibiting the pathological release of the excitatory neurotransmitter glutamate. Indicated for focal seizures, generalized tonic-clonic seizures, Lennox-Gastaut syndrome, and maintenance treatment of bipolar I disorder to delay mood episodes.

Phenytoin is a classic hydantoin antiepileptic on the WHO Model List of Essential Medicines. It voltage- and use-dependently promotes sodium channel inactivation, stabilizing neuronal membranes and limiting the spread of seizure activity from epileptic foci. Exhibits non-linear (Michaelis-Menten) saturation pharmacokinetics, where small dose increases can produce disproportionate, toxic rises in plasma concentrations. Indicated for tonic-clonic (grand mal) seizures, focal seizures, and prevention/treatment of seizures following neurosurgery.

Sodium Valproate / Divalproex Sodium is a broad-spectrum antiepileptic and mood stabilizer on the WHO Model List of Essential Medicines. It increases brain gamma-aminobutyric acid (GABA) levels by inhibiting GABA transaminase and succinic semialdehyde dehydrogenase, while blocking voltage-gated T-type calcium channels and sustained repetitive firing of voltage-sensitive sodium channels. Indicated for generalized and focal epilepsy (absence, myoclonic, tonic-clonic seizures), acute manic episodes in bipolar disorder, and migraine prophylaxis.

Carbamazepine is an iminostilbene dibenzazepine antiepileptic on the WHO Model List of Essential Medicines. It voltage- and use-dependently blocks neuronal voltage-gated sodium channels, preventing repetitive neuronal firing and inhibiting spread of seizure discharges. It is the gold-standard first-line agent for trigeminal neuralgia. Indicated for focal (partial) seizures, generalized tonic-clonic seizures, trigeminal neuralgia, and acute mania/bipolar maintenance.

Sodium Valproate / Divalproex Sodium is a broad-spectrum antiepileptic and mood stabilizer on the WHO Model List of Essential Medicines. It increases brain gamma-aminobutyric acid (GABA) levels by inhibiting GABA transaminase and succinic semialdehyde dehydrogenase, while blocking voltage-gated T-type calcium channels and sustained repetitive firing of voltage-sensitive sodium channels. Indicated for generalized and focal epilepsy (absence, myoclonic, tonic-clonic seizures), acute manic episodes in bipolar disorder, and migraine prophylaxis.

Lacosamide is a functionalized amino acid antiepileptic. It selectively enhances the slow inactivation of voltage-gated sodium channels, differing from traditional sodium channel blockers that target fast inactivation, thereby normalizing hyper-excitable neuronal membranes without disrupting physiological activity. Indicated as monotherapy and adjunctive therapy for partial-onset seizures in patients with epilepsy.

Oxcarbazepine is a 10-keto structural analogue of carbamazepine. It is rapidly and completely reduced by cytosolic arylketone reductase into its active 10-monohydroxy metabolite (MHD; licarbazepine), which blocks voltage-sensitive sodium channels and high-voltage-activated calcium channels. Unlike carbamazepine, it does not form a toxic epoxide intermediate and does not undergo hepatic auto-induction. Indicated as monotherapy or adjunctive therapy for partial-onset seizures with or without secondary generalization.

Oxcarbazepine is a 10-keto structural analogue of carbamazepine. It is rapidly and completely reduced by cytosolic arylketone reductase into its active 10-monohydroxy metabolite (MHD; licarbazepine), which blocks voltage-sensitive sodium channels and high-voltage-activated calcium channels. Unlike carbamazepine, it does not form a toxic epoxide intermediate and does not undergo hepatic auto-induction. Indicated as monotherapy or adjunctive therapy for partial-onset seizures with or without secondary generalization.

Oxcarbazepine is a 10-keto structural analogue of carbamazepine. It is rapidly and completely reduced by cytosolic arylketone reductase into its active 10-monohydroxy metabolite (MHD; licarbazepine), which blocks voltage-sensitive sodium channels and high-voltage-activated calcium channels. Unlike carbamazepine, it does not form a toxic epoxide intermediate and does not undergo hepatic auto-induction. Indicated as monotherapy or adjunctive therapy for partial-onset seizures with or without secondary generalization.

Brivaracetam is a 4-propyl analogue of levetiracetam with 15- to 30-fold higher binding affinity for synaptic vesicle protein 2A (SV2A). It penetrates the blood-brain barrier rapidly and provides potent anticonvulsant activity with potentially fewer neuropsychiatric and behavioral adverse reactions than levetiracetam. Indicated as monotherapy or adjunctive therapy for partial-onset seizures in patients with epilepsy aged 1 month and older.

Topiramate is a sulfamate-substituted monosaccharide antiepileptic with multiple mechanisms of action. It blocks voltage-dependent sodium channels, potentiates GABA-mediated inhibitory currents at non-benzodiazepine sites, antagonizes AMPA/kainate glutamate receptors, and weakly inhibits carbonic anhydrase isozymes CA-II and CA-IV. Indicated for partial-onset seizures, primary generalized tonic-clonic seizures, Lennox-Gastaut syndrome, and migraine prophylaxis in adults and adolescents.

Topiramate is a sulfamate-substituted monosaccharide antiepileptic with multiple mechanisms of action. It blocks voltage-dependent sodium channels, potentiates GABA-mediated inhibitory currents at non-benzodiazepine sites, antagonizes AMPA/kainate glutamate receptors, and weakly inhibits carbonic anhydrase isozymes CA-II and CA-IV. Indicated for partial-onset seizures, primary generalized tonic-clonic seizures, Lennox-Gastaut syndrome, and migraine prophylaxis in adults and adolescents.

Zonisamide is a 1,2-benzisoxazole derivative antiepileptic. It acts by blocking voltage-dependent sodium channels and reducing inward T-type calcium currents, while exhibiting weak carbonic anhydrase inhibitory activity. Indicated as adjunctive therapy in the treatment of partial-onset seizures in adults.

Zonisamide is a 1,2-benzisoxazole derivative antiepileptic. It acts by blocking voltage-dependent sodium channels and reducing inward T-type calcium currents, while exhibiting weak carbonic anhydrase inhibitory activity. Indicated as adjunctive therapy in the treatment of partial-onset seizures in adults.

Oxcarbazepine is a 10-keto structural analogue of carbamazepine. It is rapidly and completely reduced by cytosolic arylketone reductase into its active 10-monohydroxy metabolite (MHD; licarbazepine), which blocks voltage-sensitive sodium channels and high-voltage-activated calcium channels. Unlike carbamazepine, it does not form a toxic epoxide intermediate and does not undergo hepatic auto-induction. Indicated as monotherapy or adjunctive therapy for partial-onset seizures with or without secondary generalization.

Levetiracetam is a pyrrolidone derivative second-generation antiepileptic on the WHO Model List of Essential Medicines. It exhibits a unique mechanism of action, binding stereoselectively to synaptic vesicle protein 2A (SV2A) in presynaptic terminals, modulating exocytosis and restraining pathological vesicle release of excitatory neurotransmitters without affecting normal neurotransmission. Demonstrates near 100% oral bioavailability and minimal hepatic CYP450 metabolism. Indicated as monotherapy and adjunctive therapy for focal seizures, myoclonic seizures in juvenile myoclonic epilepsy, and primary generalized tonic-clonic seizures.

Levetiracetam is a pyrrolidone derivative second-generation antiepileptic on the WHO Model List of Essential Medicines. It exhibits a unique mechanism of action, binding stereoselectively to synaptic vesicle protein 2A (SV2A) in presynaptic terminals, modulating exocytosis and restraining pathological vesicle release of excitatory neurotransmitters without affecting normal neurotransmission. Demonstrates near 100% oral bioavailability and minimal hepatic CYP450 metabolism. Indicated as monotherapy and adjunctive therapy for focal seizures, myoclonic seizures in juvenile myoclonic epilepsy, and primary generalized tonic-clonic seizures.

Perampanel is a first-in-class, highly selective, non-competitive antagonist at postsynaptic alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) glutamate receptors on excitatory neurons. By targeting the primary mediator of fast excitatory synaptic transmission in the brain, it halts seizure propagation. Indicated as adjunctive therapy for partial-onset seizures and primary generalized tonic-clonic seizures.

Perampanel is a first-in-class, highly selective, non-competitive antagonist at postsynaptic alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) glutamate receptors on excitatory neurons. By targeting the primary mediator of fast excitatory synaptic transmission in the brain, it halts seizure propagation. Indicated as adjunctive therapy for partial-onset seizures and primary generalized tonic-clonic seizures.

Levetiracetam is a pyrrolidone derivative second-generation antiepileptic on the WHO Model List of Essential Medicines. It exhibits a unique mechanism of action, binding stereoselectively to synaptic vesicle protein 2A (SV2A) in presynaptic terminals, modulating exocytosis and restraining pathological vesicle release of excitatory neurotransmitters without affecting normal neurotransmission. Demonstrates near 100% oral bioavailability and minimal hepatic CYP450 metabolism. Indicated as monotherapy and adjunctive therapy for focal seizures, myoclonic seizures in juvenile myoclonic epilepsy, and primary generalized tonic-clonic seizures.

Levetiracetam is a pyrrolidone derivative second-generation antiepileptic on the WHO Model List of Essential Medicines. It exhibits a unique mechanism of action, binding stereoselectively to synaptic vesicle protein 2A (SV2A) in presynaptic terminals, modulating exocytosis and restraining pathological vesicle release of excitatory neurotransmitters without affecting normal neurotransmission. Demonstrates near 100% oral bioavailability and minimal hepatic CYP450 metabolism. Indicated as monotherapy and adjunctive therapy for focal seizures, myoclonic seizures in juvenile myoclonic epilepsy, and primary generalized tonic-clonic seizures.

Phenobarbitone (Phenobarbital) is a long-acting barbiturate anticonvulsant on the WHO Model List of Essential Medicines. It binds allosterically to GABAA receptors, prolonging the open duration of neuronal chloride ion channels, enhancing GABA-mediated inhibition, and suppressing glutamate-mediated excitation. Indicated for generalized tonic-clonic seizures, focal seizures, and neonatal seizures.

Phenobarbitone (Phenobarbital) is a long-acting barbiturate anticonvulsant on the WHO Model List of Essential Medicines. It binds allosterically to GABAA receptors, prolonging the open duration of neuronal chloride ion channels, enhancing GABA-mediated inhibition, and suppressing glutamate-mediated excitation. Indicated for generalized tonic-clonic seizures, focal seizures, and neonatal seizures.