Epilepsy is one of the most common and disabling chronic neurological disorders. Antiseizure medications (ASMs), previously referred to as anticonvulsant or antiepileptic drugs, are the mainstay of symptomatic epilepsy treatment. Epilepsy is a multifaceted complex disease and so is its treatment. Currently, about 30 ASMs are available for epilepsy therapy. Furthermore, several ASMs are approved therapies in nonepileptic conditions, including neuropathic pain, migraine, bipolar disorder, and generalized anxiety disorder. Because of this wide spectrum of therapeutic activity, ASMs are among the most often prescribed centrally active agents. Most ASMs act by modulation of voltage-gated ion channels; by enhancement of gamma aminobutyric acid-mediated inhibition; through interactions with elements of the synaptic release machinery; by blockade of ionotropic glutamate receptors; or by combinations of these mechanisms. Because of differences in their mechanisms of action, most ASMs do not suppress all types of seizures, so appropriate treatment choices are important. The goal of epilepsy therapy is the complete elimination of seizures; however, this is not achievable in about one-third of patients. Both in vivo and in vitro models of seizures and epilepsy are used to discover ASMs that are more effective in patients with continued drug-resistant seizures. Furthermore, therapies that are specific to epilepsy etiology are being developed. Currently, ~ 30 new compounds with diverse antiseizure mechanisms are in the preclinical or clinical drug development pipeline. Moreover, therapies with potential antiepileptogenic or disease-modifying effects are in preclinical and clinical development. Overall, the world of epilepsy therapy development is changing and evolving in many exciting and important ways. However, while new epilepsy therapies are developed, knowledge of the pharmacokinetics, antiseizure efficacy and spectrum, and adverse effect profiles of currently used ASMs is an essential component of treating epilepsy successfully and maintaining a high quality of life for every patient, particularly those receiving polypharmacy for drug-resistant seizures.

癫痫是最常见和致残的慢性神经系统疾病之一。抗癫痫药 (ASM)，以前称为抗惊厥药或抗癫痫药，是对症性癫痫治疗的中流砥柱。癫痫是一种多方面的复杂疾病，其治疗也是如此。目前，约有 30 种 ASM 可用于癫痫治疗。此外，一些 ASM 被批准用于治疗非癫痫疾病，包括神经性疼痛、偏头痛、双相情感障碍和广泛性焦虑症。由于这种广泛的治疗活性，ASM 是最常用的中枢活性药物之一。大多数 ASM 通过调制电压门控离子通道起作用。通过增强 γ-氨基丁酸介导的抑制作用；通过与突触释放机制的元素相互作用；通过阻断离子型谷氨酸受体；或通过这些机制的组合。由于作用机制不同，大多数 ASM 不能抑制所有类型的癫痫发作，因此选择适当的治疗方法很重要。癫痫治疗的目标是彻底消除癫痫发作；然而，这在大约三分之一的患者中是无法实现的。癫痫发作和癫痫的体内和体外模型都用于发现对持续耐药性癫痫发作的患者更有效的 ASM。此外，正在开发针对癫痫病因的疗法。目前，约 30 种具有不同抗癫痫机制的新化合物正处于临床前或临床药物开发过程中。而且，具有潜在抗癫痫或疾病改善作用的疗法正处于临床前和临床开发阶段。总体而言，癫痫治疗发展的世界正在以许多令人兴奋和重要的方式发生变化和发展。然而，在开发新的癫痫疗法的同时，了解目前使用的 ASM 的药代动力学、抗癫痫功效和谱以及不良反应特征是成功治疗癫痫和维持每位患者（尤其是接受多种药物治疗的患者）高质量生活的重要组成部分用于耐药性癫痫发作。