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).
