As the different types of seizure are diverse, so too are the different treatments that are used.
Treatment specificity is especially true with the absence type seizure.
Animal models have been useful for identiying drugs useful for treating epilepsy.
maximal elecroshock tests mimicks generalized tonic0clonic seizures and complex partial seizures
limbic seizures brought on by electrical kindling mimicks complex partial seizures
All anticonvulsant drugs have idiosyncratic or dose-dependent side effects. Treatment doses are increased until either seizure control occurs or dose-limiting side effects appear.
Benzodiazepines can be used to end seizures.
works against a variety of seizures
good for partial seizures
Serum concentration increases by first order kinetics up to a certain point, when zero order kinetics take place.
It can be difficult to adjust serum concentrations when jumping past this point, which represents the exhaustion of the body's excretion capacity.
Increase dosage by 50 mg and reassess levels after 5-7 days, as the half-life is ~20h.
valproic acid - generalized seizures
~11% rate of congenital malformations; spina bifida and neural tube defects, heart defects, IUGR
ASA, used regularly for analgesia, can reduce valproic acid elimination
Most antiseizure drugs have oral activity, are well absorbed, and enter the CNS. Most are not highly bound to plasma proteins.
Antiseizure drugs are cleared chiefly by hepatic metabolism and clearance in stool.
Half-lives of antiseizure dtugs tend to be long - some over 12 hours.