ABSTRACT
A number of conundrums complicate the interpretation of which biochemical effects of the antiepileptic drugs (AEDs) may be related to their mood-stabilizing and other psychotropic properties. We outline several of these issues prior to consideration of actions of specific drugs because these are crucial to the interpretation of the data. The first issue to consider iswhether themechanism of action of these agents in the seizure disorders mirrors those in the psychiatric illnesses. There are diverse mechanisms of the AEDs and these may be pertinent to efficacy in different epilepsy syndromes. Some of the AEDs are thought to act by enhancing gamma-aminobutyric acid (GABA)-benzodiazepine receptor inhibition, while others are thought to decrease overexcitation, inhibiting glutamate release, or its postsynaptic receptor effects (Fig. 1).
