Neuropeptides and Neurotransmitters Involved in Generalized Epilepsy: How Can the Antiepileptic Effect be Improved?

Here, we describe the alterations of neurotransmitters and neuropeptides that act on specific subreceptors in the brain areas involved in generalized epilepsy. A neurotransmitter imbalance between GABAergic and serotonergic neurons with hypoactivity and glutaminergic and dopaminergic neurons with hyperactivity is described. Considering the alterations in neurotransmitters and neuropeptides, neural networks in the hippocampus, hypothalamus, thalamus and cortex are described. The mechanisms of action of some recently developed antiepileptic drugs are addressed. In sum, a multimodal antiepileptic pharmacotherapy acting at several specific subreceptors is suggested. We recommend the development of an antiepileptic drug, that exerts simultaneously a GABAA agonistic and an NMDA antagonistic effect.