Mechanism of Action of Newer Anticonvulsants

Bipolar disorder, like epilepsy, is episodic in nature. It should not be surprising, then, that anticonvulsants such as carbamazepine and valproate have proven efficacy as mood stabilizers. The newer anticonvulsants—agents like lamotrigine, gabapentin, topiramate, oxcarbazepine, and zonisamide—may also be effective treatments for bipolar disorder. Identifying an anticonvulsant for use in bipolar disorder should take into account not only the pathophysiology of bipolar disorder but also the mechanism of action of the anticonvulsant. This article will explore the mechanisms of action of the newer anticonvulsants and their relationship to the pathophysiology of bipolar disorder in an attempt to determine which of these agents might make effective mood stabilizers