Last reviewed:
Mar 30th 2023
M.A., LPCC
Anticonvulsants, or antiepileptics, are a class of medication that are typically used to treat epilepsy and seizures. They may also be used to treat mental health conditions such as mood disorders and are often prescribed alongside therapeutic interventions for use in this treatment.
Anticonvulsants, also referred to as antiepileptic drugs (AEDs), and mood stabilizers, are a group of medications that were first designed to treat epileptic seizures but have since been found to also be useful in the treatment of mood disorders such as bipolar [1].
Epilepsy is a neurological condition that can cause several types of seizures that start in the brain and impact the central nervous system [2].
Bipolar disorder is a mental health condition that is characterized by episodes of mania and depression [3].
Symptoms of a manic episode can include [3][4]:
Symptoms of a depressive episode can include:
As there are many different types of anticonvulsants, there are various uses for this group of anti-seizure medications, as they work in different ways in the brain. As such, the type of anticonvulsant drug that is prescribed will vary depending on the condition it is being used to treat, as well as the individual’s response to the medication [5].
There are many types of anticonvulsant medications used in the treatment of epilepsy, which are able to reduce the occurrence of seizures by acing on various channels in the brain, such as sodium and calcium channels, and reducing certain brain activity [6].
Some of these medications are also used to treat bipolar disorder, and are sometimes prescribed as an adjunctive medication alongside an antidepressant to treat other mental health conditions such as depression, anxiety, posttraumatic stress disorder (PTSD), and other mood disorders.
There have been several studies that show anticonvulsants are effective for use in treating bipolar disorder, although the results of this type of treatment may vary depending on the severity of the condition and whether mania or depression is the more prevalent symptom [3][7].
The actions of anticonvulsant medications on sodium and calcium channels have an impact on certain neurotransmitters, such as dopamine, serotonin, and GABA, which are then able to produce effects that reduce symptoms of mania and depression that occur in bipolar disorder [1].
Some of the anticonvulsant medications that are used in the treatment of bipolar disorder include carbamazepine, valproate, and lamotrigine [8].
Valproate has been found to be effective in managing acute mania and mixed mania occurring in the context of bipolar disorder and may help to reduce rapid cycling. However, it has not been shown to have much effect on depressive episodes [3][7].
Valproate increases GABA, thereby impacting dopamine and glutamate in the brain, which is believed to be the mechanism by which it can reduce symptoms of mania [1].
Carbamazepine works in a similar way to valproate, also increasing GABAergic activity. It has been shown to be effective in reducing symptoms of acute mania and managing rapid cycling between episodes [9]. Carbamazepine is also somewhat effective in reducing the severity of depressive episodes [7].
Lamotrigine is considered a fairly unique anticonvulsant treatment for bipolar disorder, as it is much more effect than other medications of this class in treating depressive episodes. However, it has not shown much efficacy in managing manic symptoms [7][9].
Lamotrigine inhibits the reuptake of serotonin and norepinephrine, increasing levels of these neurotransmitters in the brain, thereby contributing to its antidepressant action and also making it a commonly prescribed medication for the treatment of depression [1][3].
When taking a new medication, it is common to experience side effects. Usually, these will reduce as your body adjusts to the medication. However, if these adverse effects continue or become problematic, it is important to contact your doctor, as you may need a reduced dose or a change of medication.
Common side effects of anticonvulsant medications include [3][7]:
Sometimes, anticonvulsant medications can cause serious side effects. These may be signs of a severe condition, such as liver toxicity, kidney disease, allergic reaction, skin disorder, or pancreatitis. If you experience any of the following side effects, contact your doctor immediately [7][10][11]:
Anticonvulsant medications can cause unexpected changes in mental state, such as new or worsening agitation, anxiety, mania, or depression, and may cause suicidal thoughts [10][11].
If you or your family members notice any concerning changes in your mental state, or you experience any thoughts of harming yourself, contact your doctor or mental health professional immediately.
Anticonvulsant medications are often prescribed for uses that are approved by the US Food and Drug Administration (FDA) and for others that are not approved but have been deemed necessary for treatment by a medical professional. The type of anticonvulsant prescribed will depend on the condition that is being treated.
Common uses of anticonvulsant medications include the treatment of [5][6]:
Anticonvulsant medication is the most effective treatment for epilepsy and seizures. As there are many different types of anticonvulsant medication, it may require the trial of several medications before finding the most effective treatment [5][12].
Aside from medication, treatment for epilepsy and seizures may involve [12]:
Bipolar disorder is often effectively managed with the use of medication and therapeutic treatment [13].
While anticonvulsant medications can be effective treatment as a mood stabilizer for bipolar disorder, some people require the use of other medications, or a combination of medications to effectively manage their symptoms. This might include [3][8][13][14]:
It is crucial to always take your medication exactly as prescribed by your doctor to prevent serious adverse events or a worsening of symptoms. Also, ensure that you inform your doctor of any concerning side effects that you experience, as you may need a change in dosage or medication.
Utilizing therapy alongside medication is often the most effective way to manage symptoms of bipolar disorder. This may include [13][14]:
If there is a risk of serious harm to the individual or others, inpatient treatment in a mental health hospital may be required, in order to stabilize symptoms. Typically, this is only required short-term, with the individual being discharged from hospital as soon as their condition is stable, and they are deemed to be safe from harm [14].
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