What Is the Difference Between Anticonvulsant Drugs vs. Antiepileptic Drugs?

Antiepileptic and anticonvulsant are both terms that refer to the same drugs that target different neural pathways to reduce seizure episodes in people with epilepsy disorders.

Anticonvulsants are another name for antiepileptic drugs, which are medications used to treat seizure disorders and help suppress seizures. They are also called antiseizure drugs. 

There are several types of anticonvulsants/antiepileptic drugs that are categorized by their mode of action. The choice of which antiseizure drug to use is based on:

• Each individual drug’s properties
• The potential for drug-drug interactions
• Side effect profiles and toxicities
• The known or suspected mechanism of action of the medication
• Important pharmacologic properties

Drugs which aim to regulate electrical signalling by altering sodium currents in neurons are the most common type of antiseizure drug:

• Carbamazepine (Tegretol XR, Equetro, Tegretol)
• Cenobamate (Xcopri)
• Eslicarbazepine (Aptiom, Zebinix)
• Felbamate (Felbatol)
• Lacosamide (Vimpat)
• Lamotrigine (Lamictal)
• Oxcarbazepine (Trileptal, Oxtellar XR)
• Phenytoin (Dilantin)
• Rufinamide (Banzel)
• Topiramate (Topamax)
• Valproate (Depakote)
• Zonisamide (Zonegran)

Drugs which aim to regulate electrical signalling by altering calcium currents in neurons are also used as antiseizure medications:

• Carbamazepine (Tegretol XR, Equetro, Tegretol)
• Ethosuximide (Zarontin)
• Felbamate (Felbatol)
• Gabapentin (Neurontin)
• Lamotrigine (Lamictal)
• Levetiracetam (Keppra)
• Oxcarbazepine (Trileptal, Oxtellar XR)
• Phenobarbital
• Phenytoin (Dilantin)
• Pregabalin (Lyrica)
• Primidone (Mysoline)
• Topiramate (Topamax)
• Valproate (Depakote)
• Zonisamide (Zonegran)

Drugs which aim to regulate electrical signalling by altering potassium channels in neurons are also used as antiseizure medications:

• Levetiracetam (Keppra)
• Oxcarbazepine (Trileptal, Oxtellar XR)

Some anticonvulsants affect the activity of GABA, a crucial neurotransmitter, to reduce seizures: 

• Benzodiazepines 
  • Clobazam (Frisium, Urbanyl, Onfi, Tapclob)
  • Lorazepam (Ativan)
  • Diazepam (especially rectal or nasal diazepam)
  • Nasal midazolam (Nayzilam)
• Phenobarbital
• Tiagabine (Gabitril)
• Vigabatrin (Sabril)

Other seizure drugs alter the function of glutamate receptors on neurons to reduce epileptic episodes:

• Felbamate (Felbatol)
• Perampanel (Fycompa)
• Topiramate (Topamax)

Drugs that work in other ways to reduce seizures include:

• Brivaracetam (Briviact)
• Cannabidiol (CBD)
• Levetiracetam (Keppra)
• Pregabalin (Lyrica)
• Stiripentol (Diacomit)

Common side effects of anticonvulsant/antiepileptic drugs include:

• Low blood sodium (hyponatremia)
• Bone loss 
  • Higher risk for bone disease
  • Higher risk for falls and physical trauma related to seizures 

Rare but serious side effects of anticonvulsant/antiepileptic drugs include:

• Increased risk of suicidal ideation and suicidal behavior
• Severe skin reactions
  • Stevens-Johnson syndrome 
  • Toxic epidermal necrolysis 
  • Drug reaction with eosinophilia and systemic symptoms (DRESS)