Epilepsy pills

Epilepsy is a chronic neurological disease that affects the brain. An epileptic seizure is characterized by convulsions that result in loss of consciousness.

Epilepsy pills help reduce the strength of impulses that irritate nerve endings in the brain. As a result, epileptic activity decreases, which helps normalize its functioning.

Indications epilepsy pills

The medications are indicated for partial seizures with simple or complex symptoms, psychomotor seizures, sleep seizures, diffuse seizures, and mixed types of epilepsy. They are also prescribed for the following forms of epilepsy: akinetic, juvenile melanoma, submaximal, and IGE.

Names of pills for epilepsy

The most popular drugs for epilepsy are the following tablets: carbamazepine, valproates, pyrimidone, clonazepam, phenobarbital, benzodiazepines, phenitone.

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Finlepsin

Finlepsin is an antiepileptic drug based on carbamazepine, which helps to normalize mood, has an antimanic effect. It is used as a primary drug or in combination with other medications, because it can increase the anticonvulsant threshold, thereby simplifying socialization for people who suffer from epilepsy.

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Carbamazepine

Carbamazepine is a derivative of dibenzoazepine. The drug has antidiuretic, antiepileptic, neuro- and psychotropic effects. It helps to normalize the state of membranes of irritated neurons, suppresses serial neuronal discharges and reduces the strength of neurotransmission of nerve impulses.

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Seizur (Phenytoin, Lamotrigine)

Seizar is an anticonvulsant drug. It affects the Na+ channels of the presynaptic membrane, reducing the force of mediator release through the synaptic cleft. Primarily, this suppresses the excessive release of glutamate, an amino acid that has an excitatory effect. It is one of the main irritants that create epileptic discharges in the brain.

Phenobarbital

Phenobarbital has an anticonvulsant, hypnotic, sedative and antispasmodic effect. It is used in combination therapy for epilepsy, combining it with other medications. Basically, such combinations are selected for each patient individually, based on the general condition of the person, as well as the course and form of the disease. There are also ready-made combination drugs based on phenobarbital - these are pagluferal or gluferal, etc.

Clonazepam

Clonazepam has a calming, antiepileptic, anticonvulsant effect on the body. Since this drug has a stronger anticonvulsant effect than other drugs in this group, it is used in the treatment of convulsive diseases. Taking clonazepam reduces the strength and frequency of epileptic seizures.

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Ethosuximide

Ethosuximide is an anticonvulsant that suppresses neurotransmission in the motor areas of the cerebral cortex, thereby increasing the threshold of resistance to the occurrence of epileptic seizures.

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Sodium valproate

Sodium valproate is used both for independent treatment and together with other antiepileptic drugs. The drug itself is effective only for minor forms of the disease, but for the treatment of more severe types of epilepsy, combined treatment is necessary. In such cases, drugs such as lamotrigine or phenytoin are used as additional means.

Vigabatrin

Vigabatrin suppresses excitatory impulses in the central nervous system by normalizing the activity of GABA, which is a blocker of spontaneous neural discharges.

Pharmacodynamics

The properties of epilepsy tablets are examined in more detail using carbamazepine as an example.

The substance affects the Na+ channels of the membranes of overexcited nerve endings, reducing the effect of aspartate and glutamate on them, increases inhibitory processes, and also interacts with central P1-purinergic receptors. The drug has an antimanic effect due to the suppression of the metabolism of norepinephrine and dopamine. In generalized or partial seizures, it has an anticonvulsant effect. Effectively reduces aggression and severe irritability in epilepsy.

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Pharmacokinetics

Absorbs in the gastrointestinal tract almost completely, but rather slowly, since food products do not affect the strength and speed of the absorption process. The maximum concentration after a single dose of the tablet is reached after 12 hours. Taking (single or repeated) retard tablets gives the maximum concentration (the indicator is 25% lower) after 24 hours. Retard tablets, in comparison with other dosage forms, reduce bioavailability by 15%. It binds to blood proteins within 70-80%. Clusters occur in saliva and cerebrospinal fluid, which are proportional to the remains of the active component that has not bound to proteins (20-30%). Passes through the placenta and also gets into breast milk. The apparent volume of distribution is within 0.8-1.9 l / kg. It is biotransformed in the liver (usually via the epoxide pathway), forming several metabolites - the 10,11-trans-diol source, as well as its compounds, including glucuronic acid, N-glucuronides and monohydroxylated derivatives. The half-life is 25-65 hours, and in case of prolonged use - 8-29 hours (due to the induction of enzymes of the metabolic process). In patients taking MOS inducers (such as phenobarbital and phenytoin), this period lasts for 8-10 hours. After a single dose of 400 mg, 72% of the drug taken is excreted through the kidneys, and the remaining 28% is excreted through the intestine. 2% of untransformed carbamazepine and 1% of the active substance (10,11-epoxide derivative) enter the urine, along with about 30% of other metabolic products. In children, the elimination process is accelerated, so stronger dosages may be needed (recalculated for weight). The anticonvulsant effect can last a minimum of several hours, and a maximum of several days (in some cases 1 month). The antineuralgic effect lasts 8-72 hours, and the antimanic effect 7-10 days.

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Dosing and administration

Treatment should begin with a small dose of the medication that is indicated for the patient's form of epilepsy and seizure type. The dosage is increased if the patient does not experience side effects and the seizures continue.

Carbamazepine (finlepsin and timonil, tegretol and carbasan), diphenin (phenytoin), valproates (convulex and depakine), and phenobarbital (luminal) are used to suppress partial seizures. Valproates (average daily dosage of 1000-2500 mg) and carbamazepine (600-1200 mg) are considered the first choice. The dose should be divided into 2-3 doses.

Retard tablets or drugs with prolonged action are also often used. They should be taken 1-2 times a day (such drugs include tegretol-CR, depakin-chrono, and finlepsin-petard).

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Use epilepsy pills during pregnancy

Since epilepsy is a chronic disease that requires regular medication, it is necessary to take pills during pregnancy.

There was an opinion that AEDs may be capable of exerting a teratogenic effect, but it is now proven that the use of these drugs as the sole source of treatment for epilepsy helps to reduce the risk of inherited malformations. Studies have shown that over 10 years, with the use of AEDs, the frequency of inherited malformations decreased to 8.8% from the initial 24.1%. During the studies, such drugs as primidone, phenytoin, carbamazepine, phenobarbital, and valproic acid were used in monotherapy.

Contraindications

Tablets for epilepsy are prohibited for people suffering from drug addiction or alcoholism, as well as muscle weakness. In acute renal failure, pancreatic diseases, increased sensitivity to the drug, different types of hepatitis, hemorrhagic diathesis. It cannot be taken by those who are engaged in activities that require physical exertion and concentration.

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Side effects epilepsy pills

Anti-epileptic drugs have the following side effects: vomiting with nausea, tremors and dizziness, reflexive eye rolling or movement, problems with circulatory function, drowsiness, suppression of the vital functions of the nervous system, difficulty breathing, blood pressure disturbances, disorders of the musculoskeletal system. Long-term depression may develop, rapid fatigue and irritability are observed. Sometimes an allergy or skin rash appears, which in some cases can develop into Quincke's edema. Insomnia, diarrhea, mental disorders, tremors, vision problems, and headaches are possible.

Overdose

Overdose may cause symptoms such as CNS depression, drowsiness, disorientation, agitation, hallucinations, and coma. Hyperreflexia progressing to hyporeflexia, blurred vision, speech problems, reflexive eye movements, dysarthria, impaired motor coordination, dyskinesia, myoclonic seizures, psychomotor impairment, hypothermia, and pupillary dilation may also occur.

Possible tachycardia, fainting, decreased or increased blood pressure, difficulty breathing, pulmonary edema, gastrostasis, vomiting with nausea, decreased motor activity of the large intestine. Urinary retention, oliguria or anuria, edema, hyponatremia may be observed. Possible consequences of overdose may also include hyperglycemia, an increase or decrease in the number of leukocytes, glycosuria, and metabolic acidosis.

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Interactions with other drugs

Since lamotrigine is not capable of causing significant inhibition or induction of oxidative liver enzymes, the effect of combination with drugs that are metabolized in the cytochrome P450 enzyme system will be low.

The metabolism of drugs that are biologically transformed in the liver (microsomal oxidative enzymes are activated) is enhanced when combined with barbiturates. Therefore, the effectiveness of AND (such as acenocoumarol, warfarin, phenyinion, etc.) is reduced. In this case, when used in combination, it is necessary to monitor the level of anticoagulants in order to adjust the dosage. The effect of corticosteroids, digitalis, metronidazole, chloramphenicol and doxycycline is also reduced (the half-life of doxycycline is reduced and this effect sometimes persists for 2 weeks after discontinuing the use of the barbiturate). The same effect is exerted on estrogens, TCAs, paracetamol and salicylates. Phenobarbital reduces the absorption of griseofulvin, lowering its level in the blood.

Barbiturates unpredictably affect the metabolism of anticonvulsant drugs, hydantoin derivatives - the content of phenytoin can increase or decrease, so it is necessary to monitor the plasma concentration. Valproic acid and sodium valproate increase phenobarbital levels in the blood, and it in turn reduces the saturation of clonazepam with carbamazepine in the plasma.

In combination with other drugs that depress CNS functions (hypnotics, sedatives, tranquilizers and some antihistamines), it can cause an additive depressant effect. Monoamine oxidases prolong the effect of phenobarbital (presumably because they suppress the metabolism of this substance).

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Storage conditions

Epilepsy tablets should be stored in a dry place, protected from sunlight. The temperature should not be higher than 25 degrees.

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Shelf life

The shelf life of epilepsy tablets is 3 years.

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Epilepsy Treatment Without Pills

Epilepsy pills are not the only way to treat this disease. There are also folk methods of therapy.

One of the recipes is mistletoe tincture in alcohol (insist for a week in a dark dry place). Use 4 drops in the morning on an empty stomach for 10 days. After that, take a 10-day break and repeat the course again. An analogue of this medicine is the pink radiola tuning in alcohol.

Another treatment is with the help of "Pauline root". Dig up the plant, cut off about 50 g, wash, and pour 0.5 l of vodka. Infuse the mixture for 3 weeks in the dark. To use, dissolve the tincture in water (1 glass). Dosage: for adults, 20 drops in the morning, 25 in the afternoon, 30 before bed. For children - depending on age (if the child is 8 years old - 8 drops per glass daily 3 times a day).

In some cases, epilepsy must be treated surgically. This method is used if the patient has a symptomatic disease that has arisen as a result of a brain tumor or cavernoma. Removal of the pathological focus relieves the patient of seizures in 90% of cases.

Sometimes it is necessary to remove not only the tumor itself, but also part of the cortex around the malignant formation. To increase the effectiveness, the operation is performed using electrocorticography. It records EEG impulses emanating from the surface of the brain, which makes it possible to determine which areas of the cortex around the lesion are also involved in epileptogenic activity.

Indications for surgical treatment of epilepsy are the following factors:

• Medicines do not provide the desired effect;
• The drugs are effective, but the patient cannot tolerate the side effects that result from taking them;
• The form of epilepsy that the patient has can only be cured through surgery.