What are the side effects of antiepileptic drugs?
The first-generation antiepileptic drugs can have severe side effects and are known to cause liver damage. People taking these AEDs require regular blood tests to monitor kidney and liver functions. Some antiepileptic drugs may also adversely interact with other drugs.
Though side effects cannot be eliminated, newer drugs have been developed with:
- Better efficacy
- Fewer side effects
- Less toxicity
If given during pregnancy, many of the antiepileptic drugs can cause birth defects in the child, such as:
Some of the common antiepileptic drugs and their main possible side effects are listed below.
Brivaracetam (Briviact)
Adjunct or monotherapy for partial-onset seizures.
Side effects include:
Cannabidiol (Epidiolex)
For seizures associated with Lennox-Gastaut syndrome or Dravet syndrome.
Side effects include:
Carbamazepine (Carbatrol or Tegretol)
For partial, and generalized tonic-clonic seizures.
Side effects include:
Cenobamate (Xcopri)
Adjunct therapy to reduce seizure frequency.
Side effects include:
Clobazam (Onfi)
For partial and generalized epilepsy and as intermittent and preventive treatment.
Side effects include:
Clonazepam (Klonopin)
For myoclonic seizures and emergency treatment.
Side effects include:
Children may have hyperactivity and drooling.
Diazepam (Valium)
For short-term treatment of frequent, acute repetitive seizures.
Side effects include:
- Ataxia,
- loss of appetite,
- restlessness,
- depression,
- cardiovascular or respiratory depression.
Children may have hyperactivity and drooling.
Eslicarbazepine (Aptiom)
For partial-onset seizures.
Side effects include:
Ethosuximide (Zarontin)
Treatment for absence seizures.
Side effects include:
Ezogabine (Potiga)
Adjunct therapy for uncontrolled partial-onset seizures.
Side effects include:
- Drowsiness,
- dizziness,
- memory problems,
- fatigue,
- weakness, and
- trouble concentrating.
Felbamate (Felbatol)
Restricted to treatment of severe uncontrolled partial epilepsy or Lennox-Gastaut syndrome, because of potentially fatal toxic side effects.
Side effects include:
Fosphenytoin (Cerebyx)
For short term administration via injection or IV.
Side effects include:
- Nausea,
- vomiting,
- headache,
- dizziness,
- fatigue,
- slurred speech,
- acne,
- rash,
- increased hair growth,
- involuntary eye movements (nystagmus), and
- osteoporosis if taken over a long time.
Gabapentin (Neurontin)
For partial and secondary generalized tonic-clonic seizures.
Side effects include:
- Drowsiness,
- dizziness,
- ataxia,
- nystagmus,
- headache,
- tremor,
- fatigue,
- diplopia,
- rhinitis,
- nausea, and
- vomiting.
Lacosamide (Vimpat)
Adjunct and monotherapy for partial onset seizures in adults and adolescents over 17 years old.
Side effects include:
- Dizziness,
- fatigue,
- nausea, and
- diplopia.
Lamotrigine (Lamictal)
Inhibits release of glutamate and used as an adjunct therapy for partial onset and secondary generalized tonic-clonic seizures, transition to monotherapy and Lennox-Gastaut syndrome. Used during pregnancy because of fewer side effects.
Side effects include:
- Dizziness,
- insomnia,
- headache,
- ataxia,
- diplopia,
- tremor,
- hypersensitivity and,
- potentially fatal Stevens-Johnson rash in children.
Levetiracetam (Keppra)
Adjunct treatment for primary generalized tonic-clonic seizures, partial onset seizures, and myoclonic seizures.
Side effects include:
Midazolam (Nayzilam)
For short-term treatment of frequent, acute, repetitive seizures.
Side effects include:
- Drowsiness,
- dizziness headache,
- nose pain,
- runny nose and
- throat irritation.
Oxcarbazepine (Oxtellar XR, Trileptal)
For partial seizures.
Side effects include:
Perampanel (Fycompa)
For partial onset seizures and primary generalized tonic-clonic seizures in 12 years and older patients.
Side effects include:
- Aggression,
- hostility,
- irritability,
- anger,
- paranoia,
- euphoric mood,
- agitation, and
- mood swings.
Phenobarbital
Low-cost broad-spectrum drug effective for many types of seizures and first-line treatment for continuous seizures (status epilepticus).
Side effects include:
- Cognitive and behavior changes,
- sleepiness,
- poor concentration,
- irritability,
- ataxia, and
- decreased libido.
Long-term use may cause vitamin D and folate deficiency.
Phenytoin (Dilantin)
For partial and secondary generalized seizures, controls spread of seizures.
Side effects include:
- Nausea,
- vomiting,
- headache,
- dizziness,
- fatigue,
- slurred speech,
- acne,
- rash,
- vitamin K and folate deficiency,
- loss of libido,
- hormonal dysfunction,
- bone marrow hyperplasia and osteoporosis if taken over a long time
Pregabalin (Lyrica)
Adjunct therapy for partial-onset seizures in adults and children over one month old.
Side effects include:
Primidone (Mysoline)
For partial onset and secondary generalized seizures.
Side effects include:
- Sleepiness,
- dizziness,
- nausea,
- cognitive and
- behavior changes.
Rufinamide (Banzel)
Adjunct therapy for Lennox-Gastaut syndrome.
Side effects include:
- Drowsiness,
- dizziness,
- lack of coordination,
- trouble walking,
- fatigue,
- headache,
- nausea,
- vomiting,
- loss of appetite, and
- double/blurred vision.
Stiripentol (Diacomit)
Adjunct therapy for Dravet syndrome.
Side effects include:
- Sleepiness,
- loss of appetite,
- weight loss,
- ataxia,
- agitation,
- nausea,
- tremor,
- low muscle tone, and
- speech difficulties.
Tiagabine (Gabitril)
Adjunct treatment for refractory partial seizures.
Side effects include:
- Dizziness,
- sleepiness,
- fatigue,
- weakness,
- irritability,
- anxiety,
- depression,
- mood swings,
- psychosis,
- confusion,
- tremor,
- diarrhea,
- abdominal pain,
- headache,
- ataxia,
- pharyngitis, and
- rash.
Topiramate (Topamax)
For partial onset and secondary generalized tonic-clonic seizures, primary generalized tonic-clonic seizures, and Lennox-Gastaut syndrome.
Side effects include:
- Ataxia,
- lack of concentration,
- confusion,
- dizziness,
- fatigue,
- tingling (paresthesia) in the extremities,
- sleepiness,
- memory problems,
- depression,
- agitation, and
- slowness of speech.
Valproate, valproic acid (Depakene, Depakote)
For primary generalized seizures, photosensitive epilepsy, Lennox-Gastaut syndrome and partial seizures. Not to be used if pregnant.
Side effects include:
- Dizziness,
- nausea,
- vomiting,
- tremor,
- hair loss,
- weight gain,
- depression in adults,
- irritability in children and slowness in thinking.
Long-term use can cause bone thinning, ankle swelling and menstrual irregularity.
Hearing loss, liver damage, pancreatitis and low platelet counts are more dangerous but rare side effects.
Vigabatrin (Sabril, Vigadrone)
Adjunct therapy for adults and children over 2 years with refractory complex partial seizures and monotherapy for infantile spasms in children under 2 years of age.
Side effects include:
- Drowsiness,
- dizziness,
- difficulty concentrating,
- nausea,
- vomiting,
- diarrhea,
- headache,
- fatigue,
- weight gain, and
- vision loss.
Zonisamide (Zonegran)
Adjunct therapy for partial seizures in patients who are over 12 years old.
Side effects include:
- Dizziness,
- drowsiness,
- fatigue,
- anorexia,
- headache,
- ataxia,
- speech abnormalities,
- irritability,
- mental slowing,
- weight gain,
- kidney stones and
- Stevens-Johnson rash.
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