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Anticonvulsant Agents: Principal Considerations on Effectiveness, Side Effects, and Interactions

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NeuroPsychopharmacotherapy

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Abstract

Epilepsy is one of the most common neurological disorders. Anticonvulsant agents, or antiepileptic drugs (AEDs), are the mainstay of therapy. Many AEDs have other approved and off-label uses for non-epilepsy conditions, some of which may also occur in patients with epilepsy (often called comorbidities), including mood disorders (depression, anxiety) as well as migraine headache and other types of pain. The goal of using AEDs to treat seizures in patients with epilepsy is to completely prevent the seizures from occurring without bothersome or disabling side effects and with minimal interference with other medications that patients take. Choosing from among the available AEDs for a particular patient with epilepsy requires an assessment of the patient’s type of seizures, the urgency of achieving an effective dose, awareness of the patient’s other medical problems, and knowledge about the indications, pharmacology, pharmacokinetics, side effects, and potential for drug-drug interactions of AEDs, as well as patient-relevant psychosocial issues such as comorbid psychiatric conditions, likelihood of adherence to prescribed therapy, and ability to pay for the AEDs. For patients who become seizure-free on AED therapy for a prolonged period, the pros and cons of stopping therapy include actual or potential long-term AED side effects, the patient’s seizure type(s), risk of teratogenesis, psychosocial risks of seizure recurrence such as loss of driving privileges or work activities, and the chances that resumption of AED treatment will not once again fully bring seizures under control.

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Authors and Affiliations

  1. Departments of Neurology, Beth Israel Deaconess Medical Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Steven C. Schachter

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  1. Steven C. Schachter
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Correspondence to Steven C. Schachter .

Editor information

Editors and Affiliations

  1. Dept Psychiatry , Psychosomatics & Psychotherapy, University of Würzburg, Medical School Clinical Neurochemistry, Würzburg, Germany

    Peter Riederer

  2. Inst für Psychologische Medizin, Haag, Bayern, Germany

    Gerd Laux

  3. Department of Psychiatry, University of Toronto Department of Psychiatry, Toronto, ON, Canada

    Benoit Mulsant

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Fujita Health University School Medicine, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

Section Editor information

  1. Beta Neurology – Competence Center for Epilepsy, Beta Klinik GmbH, Bonn, Germany

    Christian E. Elger

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Schachter, S.C. (2020). Anticonvulsant Agents: Principal Considerations on Effectiveness, Side Effects, and Interactions. In: Riederer, P., Laux, G., Mulsant, B., Le, W., Nagatsu, T. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_280-1

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  • DOI: https://doi.org/10.1007/978-3-319-56015-1_280-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56015-1

  • Online ISBN: 978-3-319-56015-1

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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