Anticonvulsants are a wide category of drugs that are used to treat epilepsy and other causes of seizures. Many convulsants are also used to treat muscle spasms, nerve pain, and issues like fibromyalgia. These drugs work in many different ways, and they come with a variety of potential side effects and drawbacks. Some can cause chemical dependence, addiction, and substance use disorders. Which antiepileptic drugs are abused, and how likely are they to cause substance use disorders. Learn more about anticonvulsant abuse and how it can be treated.
What are Anticonvulsants?
Anticonvulsants are a group of drugs that work to slow down central nervous system activity in order to treat epileptic seizures. Anticonvulsants are also called antiepileptic drugs because of their use in treating epilepsy. They may also be used to treat other medical and psychological disorders, including neuropathic pain, mood disorders, and borderline personality disorder. When it comes to treating tonic-clonic seizures, anticonvulsants can stop the excessive firing of neurons in the brain, which causes convulsions, tremors, and other seizure symptoms. They may also help stop seizures from spreading to other parts of the brain.
It’s unclear how some anticonvulsants work to provide their intended effects, and there are several different drugs that fit into this category. There are also different kinds of seizures that may be treated best with one anticonvulsant over another. Finding the right anticonvulsant for your needs will depend on your needs, and your doctor can help you wade through the available medications. Seizures and neuropathy-related symptoms that anticonvulsants can be used to treat are the following:
- Cluster headaches
- Restless leg syndrome
- Bipolar disorder
- Manic episodes
- Withdrawal from certain drugs
Anticonvulsants are prescription drugs in the United States and they should only be taken when directed by a doctor. Some anticonvulsant drugs are federally controlled substances, especially drugs in the benzodiazepine or barbiturate classes.
What are Some Common Anticonvulsants?
There are many different anticonvulsant medications, and several different categories in this class. Other medications can come with varying levels of addiction risk, depending on their kind. Here are some of the most common anticonvulsants:
- Carbamazepine. This is sold under the brand names Tegretol and Carbatrol. It’s among the first lines of defense against epilepsy that requires prescription medications. Carbamazepine is a partial seizure medication, which means it’s used to treat seizures that affect a small area of the brain.
- Clonazepam. Clonazepam is sold under the brand name Klonopin in the United States. It’s in a class of drugs called benzodiazepines, which are also used to treat anxiety and insomnia. It has sedative qualities, so it may cause drowsiness and sleepiness in some people that are taking it for epilepsy.
- Gabapentin. Gabapentin is sold under the brand name Neurontin. Like other anticonvulsants, it works by influencing GABA, a natural neurotransmitter that’s responsible for slowing down your nervous system. It can also be used to treat nerve pain.
- Lacosamide. This drug is sold under the brand name Vimpat. It’s relatively new, and it was just approved for medical use in the United States in 2009. It works differently than other anticonvulsants. It has a unique way of blocking sodium channels to treat partial seizures.
- Lamotrigine. Lamotrigine is sold under the brand name Lamictal, and it’s used to treat bipolar disorder and seizures. It works in the brain in several ways, especially by blocking glutamate release. It may not be as effective in treating a certain type of seizure called a myoclonic seizure.
- Levetiracetam. This drug is sold as Keppra, and it’s fairly popular as a seizure medication. It’s effective for several different types of seizures with few serious side effects. It’s also sold in extended-release forms that release a larger dose over a long time.
- Lorazepam. Lorazepam is sold under the well-known brand name Ativan. It’s a benzodiazepine like Klonopin, but it’s short-acting. It’s often used in emergency medicine because it doesn’t take very long to begin working. It may be used to treat people that experience cluster headaches, which are severe and come on suddenly.
- Oxcarbazepine. This drug is sold under the brand name Trileptal. It’s similar to carbamazepine with some differences. It’s used to treat partial seizures in adults and children that are at least four years old. It may also be used to treat mood disorders off-label.
- Phenobarbital. This is a barbiturate that’s sold under the brand name Luminal. Barbiturates are old medications that have been used since the late 19th century. Luminal has been used to treat partial and tonic-clonic seizures for 80 years. However, barbiturates are potent and can have serious side effects, especially when it’s taken in high doses.
- Pregabalin. Pregabalin is sold under the name Lyrics, and it’s similar to gabapentin. It also works with GABA to produce its desired effects. It may also be used to treat fibromyalgia and nerve pain. It may be more common to use it as a nerve and muscle pain treatment than a treatment for epilepsy.
Are Anticonvulsants Addictive?
Some anticonvulsants do come with some addiction risk, but since this is such a broad category, many of its members also have a very low risk of addiction. Still, many anticonvulsant medications can cause dependence, addiction, and substance use disorders when they are used for too long, misused, or abused as a recreational drug. Here are some types of anticonvulsants that may be misused or abused, leading to addiction.
Barbiturates are among the most addictive drugs that are used to treat seizures. They are among the first central nervous system depressants used in modern medicine, and many have been replaced by other options. Still, drugs like phenobarbital continue to be used today. Barbiturates are potent medications that can be used to treat seizures and other issues that are resistant to other treatments. However, phenobarbital, like other barbiturates, are federally controlled.
Barbiturates can cause chemical dependence with just a few weeks of regular use. Dependence can cause uncomfortable and even dangerous withdrawal symptoms when you try to quit or cut back. Phenobarbital is typically only prescribed for short-term therapeutic use, and regular use longer than two weeks is avoided.
Barbiturates may also be misused or abused as recreational drugs. They work in a way that’s similar to alcohol, and they can cause a relaxing, intoxicating high. Doses that are too high can cause dangerous overdose symptoms like respiratory depression. Barbiturates are even more dangerous when mixed with alcohol, opioids, or other central nervous system depressants.
Benzodiazepines are a popular class of central nervous system depressants. They were first introduced in the 1960s, and they became the most popular prescriptions in the world by the 1970s. Benzodiazepines replaced barbiturates for common uses like insomnia and anxiety. Their popularity grew, partly because they have a safer side effects profile when compared to barbiturates. However, benzodiazepines can cause substance use disorders and chemical dependence.
Like barbiturates, benzodiazepines can cause chemical dependence and dangerous withdrawal symptoms after several weeks of regular use. For instance, lorazepam may lead to tolerance or dependence after four weeks of consistent use, so it may not be ideal for someone that needs daily medications.
Benzodiazepines are less likely to cause a deadly accidental overdose than barbiturates, but they can cause some dangerous overdose symptoms. Benzodiazepines are more likely to cause a dangerous or life-threatening overdose when they’re mixed with alcohol or opioids. Like barbiturates, they can cause respiratory depression, which can be deadly.
Gabapentin and Pregabalin
Gabapentin and pregabalin work in similar ways that are distinct from benzodiazepines and barbiturates. While they do influence GABA, they don’t bind to GABA receptors directly like benzodiazepines and barbiturates. Instead, they inhibit certain calcium channels from facilitating their effects. They also influence the creation of an enzyme that’s responsible for synthesizing GABA. Gabapentin and similar drugs don’t bind to benzodiazepine, opioid, or cannabinoid sites in the brain, which are often associated with addiction.
However, the Food and Drug Administration (FDA) reports that there have been cases of gabapentin misuse and abuse. In those cases, people were taking the drug in doses that were higher than recommended. There are also some examples of withdrawal symptoms caused by gabapentin. Withdrawal is especially associated with abrupt discontinuation of the drug.
Gabapentin and pregabalin aren’t associated with substance use disorder in the same way that benzodiazepines or barbiturates are. But they are federally controlled substances with some risk of abuse and addiction, though serious substance use disorders that involve these drugs are rare.
How is Anticonvulsant Addiction Treated?
If you feel like you’ve become dependent or addicted to an anticonvulsant drug, you should speak to a doctor or addiction treatment professional as soon as possible. You shouldn’t try to quit an anticonvulsant cold-turkey, especially if you’ve had seizures in the past. Quitting this type of medication abruptly can cause seizures, convulsions, and a potentially life-threatening condition called delirium tremens.
Your doctor may be able to help you taper off the medication safely. Tapering can be a delicate process, and it’s important to approach it with medical help. If necessary, you may need to go through an addiction treatment program, starting with medical detox.