Anticonvulsant Drugs: The Issues

Anticonvulsant drugs as a group are fifth among the most prescribed drugs in the United States,1 with more than 56 million prescriptions written in the past year. Now used to treat a variety of conditions arising in the central nervous system, anticonvulsants were originally designed to prevent seizures. Seizures are episodic neurological events that produce convulsions or temporary changes in awareness or behavior. They are the defining symptoms of epilepsy, a disorder of the brain that has been recognized since ancient times and that currently affects about 2.7 million Americans of both sexes. Some anticonvulsants — there are more than 20 on the market — have been available for decades. Others have been developed more recently. Both men and women take anticonvulsants; however, research is showing that there are gender-related effects specific to women and their reproductive health.

Today, anticonvulsants are widely prescribed for women who do not have epilepsy. Increasingly, they are being used to treat a broad range of other chronic conditions affecting the central nervous system, including migraine, severe pain caused by damaged nerves (neuropathic pain), and bipolar and associated mood disorders. Valproate is used in the treatment of migraine. Valproate, lamotrigine, and carbamazepine are used in the treatment of bipolar disorder; gabapentin and topiramate are being studied for similar use. Carbamazepine and gabapentin may be prescribed for neuropathic pain. It is estimated that as many as 24 million American women may at some time in their lives be treated with anticonvulsant drugs — including a million women with epilepsy, a million women with bi polar or other mood disorders, a million with neuropathic pain, and about 21 million with migraine headaches.

The Epilepsy Foundation’s Anticonvulsants and Women: A Call to Action campaign is based on the belief that all women being treated with these medications need information about gender-related risk factors so that they will be able to work more effectively with their physicians, nurses, midwives, and other healthcare providers and make informed choices about their care.