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In terms of the mechanism of action of benzodiazepines, their similarities are too great to separate them into individual categories such as anxiolytic or hypnotic. For example, a hypnotic administered in low doses produces anxiety-relieving effects, whereas a benzodiazepine marketed as an anti-anxiety drug at higher doses induces sleep. [182]
Anticonvulsants suppress the excessive rapid firing of neurons during seizures. [6] Anticonvulsants also prevent the spread of the seizure within the brain. [7] Conventional antiepileptic drugs may block sodium channels or enhance γ-aminobutyric acid function. Several antiepileptic drugs have multiple or uncertain mechanisms of action. [8]
Its mechanism of action works by increasing the effect of the neurotransmitter gamma-aminobutyric acid (GABA). [20] Diazepam was patented in 1959 by Hoffmann-La Roche. [15] [22] [23] It has been one of the most frequently prescribed medications in the world since its launch in 1963. [15]
Because clonazepam is effective in low milligram doses (0.5 mg clonazepam = 10 mg diazepam), [118] [119] it is said to be among the class of "highly potent" benzodiazepines. [120] The anticonvulsant properties of benzodiazepines are due to the enhancement of synaptic GABA responses, and the inhibition of sustained, high-frequency repetitive firing.
In humans, tolerance to the anticonvulsant effects of clobazam may occur [27] and withdrawal seizures may occur during abrupt or over-rapid withdrawal. [28] Clobazam as with other benzodiazepine drugs can lead to physical dependence, addiction, and what is known as the benzodiazepine withdrawal syndrome.
Levetiracetam, sold under the brand name Keppra among others, is a novel antiepileptic drug [7] used to treat epilepsy. [8] It is used for partial-onset, myoclonic, or tonic–clonic seizures, [7] and is taken either by mouth as an immediate or extended release formulation or by injection into a vein.
Prazepam exerts its therapeutic effects primarily via modulating the benzodiazepine receptor which in turn enhances GABA function in the brain. [22] Prazepam like other benzodiazepines has anticonvulsant properties, but its anticonvulsant properties are not as potent as other benzodiazepines when tested in animal studies. [23] [24] [25] [26]
It was the first benzodiazepine to be synthesized and the discovery of chlordiazepoxide was by pure chance. [6] Chlordiazepoxide and other benzodiazepines were initially accepted with widespread public approval, but were followed with widespread public disapproval and recommendations for more restrictive medical guidelines for its use. [7]