A report on Anticonvulsant

Carbamazepine

Anticonvulsants (also known as antiepileptic drugs or recently as antiseizure drugs) are a diverse group of pharmacological agents used in the treatment of epileptic seizures.

- Anticonvulsant
Carbamazepine

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Generalized 3 Hz spike-and-wave discharges on an electroencephalogram

Epilepsy

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Group of non-communicable neurological disorders characterized by recurrent epileptic seizures.

Group of non-communicable neurological disorders characterized by recurrent epileptic seizures.

Generalized 3 Hz spike-and-wave discharges on an electroencephalogram
A still image of a generalized seizure
A bite to the tip of the tongue due to a seizure
An EEG can aid in locating the focus of the epileptic seizure.
Revised operational scheme of seizure classification, ILAE, 2017
Wristbands or bracelets denoting their condition are occasionally worn by epileptics should they need medical assistance.
Anticonvulsants
Deaths due to epilepsy per million persons in 2012
Hippocrates, 17th century engraving by Peter Paul Rubens of an antique bust

Identifying an epilepsy syndrome is useful as it helps determine the underlying causes as well as what anti-seizure medication should be tried.

Phenobarbital

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Medication of the barbiturate type.

Medication of the barbiturate type.

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Phenobarbital was discovered in 1912 and is the oldest still commonly used anti-seizure medication.

Carbamazepine

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Tegretol 200-mg CR (made in NZ)
Metabolism. Top: carbamazepine • middle: carbamazepine-10,11-epoxide, the active metabolite • bottom: carbamazepine-10,11-diol, an inactive metabolite, which is then glucuronidized

Carbamazepine (CBZ), sold under the trade name Tegretol among others, is an anticonvulsant medication used primarily in the treatment of epilepsy and neuropathic pain.

500mg tablets of Depakote extended-release

Valproate

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Valproate (VPA) and its valproic acid, sodium valproate, and valproate semisodium forms are medications primarily used to treat epilepsy and bipolar disorder and prevent migraine headaches.

Valproate (VPA) and its valproic acid, sodium valproate, and valproate semisodium forms are medications primarily used to treat epilepsy and bipolar disorder and prevent migraine headaches.

500mg tablets of Depakote extended-release
Some metabolites of valproic acid. Glucuronidation and β-oxidation are the main metabolic pathways; ω-oxidation metabolites are considered hepatotoxic. Details see text.

Valproate has a broad spectrum of anticonvulsant activity, although it is primarily used as a first-line treatment for tonic–clonic seizures, absence seizures and myoclonic seizures and as a second-line treatment for partial seizures and infantile spasms.

Generalized 3 Hz spike-and-wave discharges on an electroencephalogram

Status epilepticus

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Single seizure lasting more than 5 minutes or 2 or more seizures within a 5-minute period without the person returning to normal between them.

Single seizure lasting more than 5 minutes or 2 or more seizures within a 5-minute period without the person returning to normal between them.

Generalized 3 Hz spike-and-wave discharges on an electroencephalogram
Diazepam that can be inserted rectally is often prescribed to caregivers of people with epilepsy. This enables treatment of multiple seizures prior to being able to seek medical care.

Insufficient dosage or sudden withdrawal of a medication (especially anticonvulsants)

Generalized 3 Hz spike and wave discharges in EEG

Seizure

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Period of symptoms due to abnormally excessive or synchronous neuronal activity in the brain.

Period of symptoms due to abnormally excessive or synchronous neuronal activity in the brain.

Generalized 3 Hz spike and wave discharges in EEG
An individual who has bitten the tip of their tongue while having a seizure
An EEG can aid in locating the focus of the epileptic seizure.

A first seizure generally does not require long-term treatment with anti-seizure medications unless a specific problem is found on electroencephalogram (EEG) or brain imaging.

0.5 mg tablets of the Ativan brand of lorazepam

Lorazepam

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Benzodiazepine medication.

Benzodiazepine medication.

0.5 mg tablets of the Ativan brand of lorazepam
1987 advertisement. "In a world where certainties are few...no wonder Ativan is prescribed by so many caring clinicians."

Lorazepam's anticonvulsant properties and pharmacokinetic profile make intravenous use reliable for terminating acute seizures, but induce prolonged sedation.

Bipolar disorder is characterized by episodes of depression and mania.

Bipolar disorder

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Mood disorder characterized by periods of depression and periods of abnormally-elevated happiness that last from days to weeks each.

Mood disorder characterized by periods of depression and periods of abnormally-elevated happiness that last from days to weeks each.

Bipolar disorder is characterized by episodes of depression and mania.
Bipolar mood shifts
An 1892 color lithograph depicting a woman diagnosed with hilarious mania
An 1858 lithograph captioned 'Melancholy passing into mania'
'Melancholy' by William Bagg, after a photograph by Hugh Welch Diamond
Brain imaging studies have revealed differences in the volume of various brain regions between patients with bipolar disorder and healthy control subjects.
Since Emil Kraepelin's distinction between bipolar disorder and schizophrenia in the 19th century, researchers have defined a spectrum of different types of bipolar disorder.
Simplified graphical comparison of bipolar I, bipolar II and cyclothymia
Lithium is the only medication approved by the FDA for treating mania in children.
Lithium is often used to treat bipolar disorder and has the best evidence for reducing suicide.
German psychiatrist Emil Kraepelin first distinguished between manic–depressive illness and "dementia praecox" (now known as schizophrenia) in the late 19th century.
Singer Rosemary Clooney's public revelation of bipolar disorder made her an early celebrity spokesperson for mental illness.

Mood stabilizers—lithium and certain anticonvulsants such as valproate and carbamazepine as well as atypical antipsychotics such as aripiprazole—are the mainstay of long-term pharmacologic relapse prevention.

The mechanism of action of phenytoin sodium. Sodium channels are: 1) Closed 2) Open 3) Inactive (phenytoin effect)

Phenytoin

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The mechanism of action of phenytoin sodium. Sodium channels are: 1) Closed 2) Open 3) Inactive (phenytoin effect)

Phenytoin (PHT), sold under the brand name Dilantin among others, is an anti-seizure medication.

Primidone

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Barbiturate medication that is used to treat partial and generalized seizures, as well as essential tremors.

Barbiturate medication that is used to treat partial and generalized seizures, as well as essential tremors.

Dupuytren's contracture of the fourth digit (ring finger).
Radiograph of a rickets sufferer

Primidone is an anticonvulsant of the barbiturate class.