barbiturates (primidone [Mysoline], phenobarbital)

Systemic side effects Neurotoxic side effects Rare, idiosyncratic reactions
nausea altered sleep cycles  
rash sedation  
  lethargy  
  behavioral changes  
  hyperactivity  
  ataxia  
  tolerance  
  dependence  

 

carbamazepine (Tegretol, Tegretol-XR, Carbatrol)

Systemic side effects Neurotoxic side effects Rare, idiosyncratic reactions
nausea drowsiness agranulocytosis
vomiting dizziness Stevens-Johnson syndrome
diarrhea blurred or double vision aplastic anemia
hyponatremia lethargy hepatic failure
fluid retention headache dermatitis, rash
rash, pruritus   serum sickness
    pancreatitis

 

ethosuximide (Zarontin)

Systemic side effects Neurotoxic side effects Rare, idiosyncratic reactions
nausea sleep disturbance  
vomiting drowsiness  
  hyperactivity  

 

felbamate (Felbatol)

Felbamate is recommended for use only by patients who respond inadequately to alternative treatments and whose epilepsy is so severe that a substantial risk of aplastic anemia, liver failure, or both is deemed acceptable in light of the benefits of its use.

Systemic side effects Neurotoxic side effects Rare, idiosyncratic reactions
nausea insomnia aplastic anemia
vomiting dizziness liver failure
anorexia headache  
weight loss ataxia  

 

gabapentin (Neurontin)

Systemic side effects Neurotoxic side effects Rare, idiosyncratic reactions
none known somnolence unknown
  dizziness  
  ataxia  

 

lamotrigine (Lamictal)

Systemic side effects Neurotoxic side effects Rare, idiosyncratic reactions
rash dizziness Stevens-Johnson syndrome
nausea somnolence hypersensitivity syndrome

 

phenytoin (Dilantin, Phenytek)

Systemic side effects Neurotoxic side effects Rare, idiosyncratic reactions
gingival hypertrophy confusion rash
hirsutism slurred speech lymphadenopathy
rash double vision  
lymphadenopathy ataxia  
osteomalacia (with long-term use) neuropathy (with long-term use)  

 

valproate (Depakote, Depakote ER, Depakene, valproic acid)

Systemic side effects Neurotoxic side effects Rare, idiosyncratic reactions
weight gain tremor pancreatitis
nausea, vomiting tiredness thrombocytopenia
hair loss   impaired platelet function
With long-term use: bone loss, menstrual irregularity, PCOS   liver failure (especially in children <2 yr)

 

Adapted from: Schachter SC. Treatment of seizures. In: Schachter SC, Schomer DL, eds. The comprehensive evaluation and treatment of epilepsy. San Diego, CA: Academic Press; 1997. p. 61-74. With permission from Elsevier (www.elsevier.com).

Authored By: 
Steven C. Schachter MD
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Authored Date: 
12/2003