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Seizure Medications (cont.)

Medical Editor:

What are the most common seizure medications?

First-line therapy for generalized tonic-clonic (grand mal) seizures includes valproic acid (Depakene, Depakote), lamotrigine (Lamictal) and topiramate (Topamax).

For partial seizures, common first-line medications include carbamazepine (Tegretol), phenytoin (Dilantin), Oxcarbazepine (Trileptal) and, especially in children, ethosuximide (Zarontin).

Additionally, phenobarbital is often the medication of choice for seizures in very young children.

What are common seizure medication side effects?

Because seizure medications work in the central nervous system, most cause some degree of drowsiness or dizziness, at least at the beginning of therapy. Also, most anti-seizure medications can induce suicidal thoughts or actions, and/or bring on or worsen depression.

Seizure medications have a variety of possible side effects. The following is a list of potential side effects of different classes of seizure medications.

Acetazolamide (Diamox):

Benzodiazepines (Valium, Ativan, Klonopin, Onfi):

  • Dependence
  • Possible severe seizures on sudden withdrawal
  • Respiratory depression
  • Increased risk of glaucoma
  • Liver injury

Carbamazepine (Tegretol) and related drugs:

  • Upset stomach
  • Serious (even fatal) skin reactions
  • Serious blood disorders
  • Reduced sodium levels (oxcarbazepine)

Ethosuximide (Zarontin) and derivatives:

  • Serious blood disorders

Ezogabine/Retigabine (Potiga):

  • Potentially irreversible eye damage
  • Potentially irreversible skin discoloration

Felbamate (Felbalol):

  • Liver failure
  • Potentially fatal anemia (aplastic anemia)

Gabapentin (Neurontin):

Lacosamide (Vimpat):

  • Skin rash
  • Changes in heartbeat with possible fainting
  • Drug dependence

Lamotrigine (Lamictal):

  • Serious rash
  • Stomach problems
  • Difficulty sleeping

Levetiracetam (Keppra, Keppra XR):

Perampanel (Fycompa):

  • Severe changes in mood and behavior, including hostility, aggression, suicidal thoughts
  • Weight gain
  • Drug dependence

Phenobarbital and derivatives:

Phenytoin (Dilantin):

  • Body hair growth
  • Birth defects
  • Gum disease
  • Seizures with higher doses

Pregabalin (Lyrica):

  • Swelling of hands and feet
  • Trouble concentrating
  • Weight gain

Rufinamide (Banzel):

  • EKG changes
  • Interference with oral contraceptives

Tiagabine (Gabitril):

  • Tremor
  • Agitation
  • Seizures in non-epilepsy patients

Topiramate (Topamax):

  • Increased risk for glaucoma
  • Trouble concentrating
  • Decreased sweating
  • Increase in body temperature

Valproic acid and derivatives (Depakene, Depakote):

  • Stomach upset
  • Temporary loss or thinning of hair
  • Pancreatitis
  • Toxicity to liver
  • Weight gain
  • Birth defects

Vigabatrin (Sabril):

  • Irreversible visual problems, including reductions in acuity and color differentiation

Zonisamide (Zonegran):

  • Kidney stones
  • Rise in body temperature
  • Metabolic acidosis
Medically Reviewed by a Doctor on 4/27/2016


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