The anticonvulsants (also called anti-seizure medications or antiepileptic drugs) are a group of drugs used to prevent or reduce the severity of epileptic fits or other convulsions. They are prescribed as well to treat bipolar disorder, fibromyalgia, and some other medical conditions. The purpose of an anticonvulsant is to suppress the rapid and excessive firing of neurons that start a seizure.
Some anticonvulsants have been around for decades. The first one – phenytoin – was approved by the FDA in 1953. It was later followed by carbamazepine, ethotoin, and valproic acid or divalproex. The above mentioned drugs and some of their offshoots are often referred to as the “first-generation” or older anticonvulsants.
As these older drugs generally have more side effects than most of the newer anti-seizure drugs, they are mainly used when the newer medications prove to be ineffective.
In the 1990s, a new group of “second-generation” anticonvulsants was developed. Some doctors had prescribed the older drugs for non-seizure-related conditions, but the development of the new drugs spurred a greatly increased use of both the old and the new anticonvulsants to treat conditions other than seizures. This primarily involved people with bipolar disorder or pain that had its’ origins in nervous system damage, trauma, or dysfunction – so called nerve pain. Anti-seizure drugs of the “second-generation” include Gabapentin (Neurontin), Oxcarbazepine (Trileptal), Topiramate (Topamax), and some others.
Gabapentin has the fewest side effects among drugs of the “second generation”, so it is generally the first anti-seizure drug prescribed in case of nerve pain.