Mechanism of Anti-seizure Medications and Emerging Trends in Epilepsy Treatment

Z. S. Rana, Reena Suman, Shobi Veleri, Pradeep Punnakkal
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Abstract

Review Mechanism of Anti-seizure Medications and Emerging Trends in Epilepsy Treatment Zubin Singh Rana 1, Reena Suman 1, Shobi Veleri 2, and Pradeep Punnakkal 1, * 1 Department of Biophysics, Postgraduate Institute of Medical Education and Research Chandigarh, 160012, India 2 Drug Safety Division, ICMR-National Institute of Nutrition, Hyderabad, 500007, India. * Correspondence: p.pradeep@pgimer.edu.in     Received: 28 November 2022 Accepted: 24 January 2023   Abstract: About one percent of the world’s population is affected by epilepsy. Epilepsy-induced psychiatric co-morbidity and mortality impose a huge burden on patients, their families, and society. Anti-seizure medications (ASMs) are drugs used to control seizures in patients with epilepsy. Epilepsy constitutes a spectrum of disorders, with various underlying causes. Hence, finding the right drug to control seizures with minimal side effects is a difficult task for clinicians. Besides controlling seizures, many ASMs have off-target effects that result in unwanted side effects. Compared to first and second-generation drugs, third-generation drugs have shown better tolerance. Even though the target of many ASMs is known, their mechanism of action is not well understood. The main mechanism behind epilepsy is defined as an imbalance in the excitatory-to-inhibitory ratio in neurotransmission. So, the key target of ASMs is the ion channels controlling the intrinsic property of neurons like sodium channels, potassium channels, and calcium channels, the excitatory synaptic transmission via glutamate receptors, and the inhibitory synaptic transmission by GABA receptors. Here we review the role of ion channels in epilepsy, and how the ASMs act on them for seizure control.
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抗癫痫药物的作用机制及癫痫治疗的新趋势
抗癫痫药物的作用机制和癫痫治疗的新趋势zubin Singh Rana 1, Reena Suman 1, Shobi Veleri 2, Pradeep Punnakkal 1, *1印度医学教育与研究研究生院生物物理学系,昌迪加尔,160012 2印度国际医学研究委员会-国家营养研究所药物安全部,海得拉巴,500007*通讯:p.pradeep@pgimer.edu.in收稿日期:2022年11月28日接受日期:2023年1月24日摘要:世界上约有1%的人口受到癫痫的影响。癫痫引起的精神疾病的合并症和死亡率给病人、他们的家庭和社会带来了巨大的负担。抗癫痫药物(asm)是用于控制癫痫患者癫痫发作的药物。癫痫是一系列疾病,有各种潜在病因。因此,找到合适的药物来控制癫痫发作和最小的副作用对临床医生来说是一项艰巨的任务。除了控制癫痫发作外,许多抗痉挛药物还会产生意想不到的副作用。与第一代和第二代药物相比,第三代药物的耐受性更好。尽管许多asm的靶点是已知的,但它们的作用机制尚不清楚。癫痫背后的主要机制被定义为神经传递中兴奋性与抑制性比例的不平衡。因此,asm的主要作用靶点是控制神经元固有特性的钠通道、钾通道、钙通道等离子通道,以及谷氨酸受体的兴奋性突触传递和GABA受体的抑制性突触传递。在这里,我们回顾离子通道在癫痫中的作用,以及asm如何作用于它们以控制癫痫发作。
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