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).