K K Jain MD (Dr. Jain is a consultant in neurology and has no relevant financial relationships to disclose.)
Originally released December 16, 1998; last updated September 14, 2020; expires September 14, 2023

Historical note and terminology

The era of antiepileptic drugs started with the introduction of bromides in 1857 and was followed by the discovery of the anticonvulsant effect of barbiturates in 1912 and by the introduction of hydantoins in 1916. Carbamazepine was introduced into clinical practice as an antiepileptic drug in 1963. Carbamazepine and lamotrigine block repetitive firing of neurons by blocking sodium channels. Gabapentin, a GABA receptor agonist, was first studied as an antiepileptic drug in humans in 1987 (Crawford et al 1987). It was launched in the United Kingdom in 1993 and approved in the United States as add-on therapy for intractable partial seizures in adults. It is also approved for the treatment of postherpetic neuralgia. Gabapentin can induce euphoria at high doses, leading to recreational abuse. As a cousin to the Schedule V drug pregabalin, it has been reclassified in the United Kingdom and in several states in United States.

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