Anticonvulsants currently used drugs

There seems no reason, therefore, to eschew the description of lithium therapy as the treatment of manic patients by lithium poisoning, in the words of an early critic (Wikler 1957). Anticonvulsants do not share the toxicity profile of lithium, but by virtue of their use to prevent epileptic fits, they all exert depressant effects on the activity of the central nervous system. With this profile of drug-induced effects in mind, let us examine the research on whether lithium or other drugs currently used in manic depression act in a disease-centred way and consider whether they have any real benefits. 

Although clinically prescribed as sedatives and anticonvulsants, benzodiazepines can be abused and therefore must be monitored in drug tests. Many GC-MS methods are currently available for the analysis of benzodiazepines [46-50]. Recent advances have been made with regards to preanalysis enzyme hydrolysis [46,48], analysis of the drugs in human tissue [47], and the investigation of new sample preparation techniques [49]. A good review of numerous techniques currently used to analyze benzodiazepines was published by Drummer [50]. 

Lithium remains the treatment of choice for bipolar patients who experience classic euphoric episodes of mania. Current evidence suggests that those with mixed episodes or rapid cycling episodes respond preferably to anticonvulsants or atypical antipsychotic drugs. In addition to its use as a mood stabilizer, lithium is effective in converting unipolar antidepressant nonresponders to responders. Finally, lithium may also be an effective treatment for patients with clnster headaches. 

Lamotngine (Lamictal). Lamotrigine, another anticonvulsant used to treat BPAD, is currently FDA approved for the prevention of both depressive and manic episodes during BPAD maintenance therapy. This represents a shift in the paradigms for BPAD therapy, as medications used to treat acute episodes have also typically been used for antimanic prophylaxis. Lamotrigine is not effective in the acute treatment of mania but has become for many the drug of choice for bipolar depression as well as for prevention of subsequent mood episodes of either polarity. 

Many anticonvulsant drugs, as a major part of their mechanism of action, block the sodium channel, but other effective agents do not use this mechanism. Which of the following anticonvulsants has the ability to block T-calcium currents as its primary mechanism of action ... 

A 24-year-old man with a history of partial seizures has been treated with standard anticonvulsants for several years. He is currently taking valproic acid, which is not fully effective and his neurologist prescribes a new drug approved for adjunctive use in partial seizures. Unfortunately, the patient develops toxic epidermal necrolysis. The new drug prescribed was... 

Benzodiazepines, therapeutically used as tranquillizers, hypnotics, anticonvulsants, and centrally acting muscle relaxants, rank among the most frequently prescribed drugs. In 1960, the first benzodiazepine, chlordiazepoxide, was introduced. To date, more than 50 benzodiazepines have been marketed in over 100 different preparations. They appear mainly as capsules and tablets, however, some are marketed in other forms such injectable solutions or powders. Benzodiazepines were introduced to replace barbiturates and methaqualone as tranquillizers, hypnotics, anticonvulsants, and muscle relaxants. Currently there are 33 benzodiazepines on the control list all of which appear as tablets or capsules, though some also appear as vials or powders for preparation of injection (Figure 7). 

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