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Adverse reactions of antiepileptic drugs

Adverse reactions of antiepileptic drugs

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 Adverse Drug Reaction Acute Side Effects 
DrugConcentration DependentIdiosyncraticChronic Side Effects
Carbamazepine

Diplopia

Dizziness

Drowsiness

Nausea

Unsteadiness

Lethargy

Blood dyscrasias

Rash (HLA antigen testing may be relevant to avoid Stevens–Johnson or toxic epidermal necrolysis)

Hyponatremia

Metabolic bone disease (monitor vit D and serum calcium)

Clobazam Somnolence Drooling  
  Sedation Aggression  
  Pyrexia Irritability  
  Ataxia Constipation  
Ethosuximide Ataxia Blood dyscrasias Behavior changes
  Drowsiness Rash Headache
  GI distress (avoid by multiple daily dosing)    
  Unsteadiness    
  Hiccoughs    
Ezogabine

Dizziness

Somnolence

Fatigue

Confusion

Vertigo

Tremors

Blurred vision

Urinary retention

QT prolongation (get baseline EKG and during treatment)

Euphoria

Not established
Felbamate Anorexia Aplastic anemia (follow CBC) Not established
  Nausea Acute hepatic failure (follow liver enzymes)  
  Vomiting    
  Insomnia    
  Headache    
Gabapentin Dizziness Pedal edema Weight gain
  Fatigue    
  Somnolence    
  Ataxia    
Lacosamide Dizziness Liver enzyme elevation Not established
  Vertigo    
  Headache    
  Nausea    
  Vomiting    
  PR interval increase (get baseline EKG and during treatment)    
Lamotrigine

Diplopia

Dizziness

Unsteadiness

Headache

Rash (slower titration of dose may decrease chance of occurrence) Not established
Levetiracetam

Sedation

Behavioral disturbance

Psychosis (rare but more common in elderly or persons with mental illness) Not established
Oxcarbazepine Sedation Rash Hyponatremia
  Dizziness    
  Ataxia    
  Nausea    
Phenobarbital Ataxia Blood dyscrasias Behavior changes
  Hyperactivity Rash Connective tissue disorders
  Headache   Intellectual blunting
  Unsteadiness   Metabolic bone disease
  Sedation   Mood change
  Nausea   Sedation
Phenytoin

Ataxia

Nystagmus

Behavior changes

Dizziness

Headache

Incoordination

Sedation

Lethargy

Cognitive impairment

Fatigue

Visual blurring

Blood dyscrasias

Rash (HLA antigen testing may be relevant to avoid Stevens–Johnson or toxic epidermal necrolysis)

Immunologic reaction

Behavior changes

Cerebellar syndrome (occurs high serum levels)

Connective tissue changes

Skin thickening

Folate deficiency

Gingival hyperplasia

Hirsutism

Coarsening of facial features

Acne

Cognitive impairment

Metabolic bone disease (monitor vit D and serum calcium)

Sedation

Pregabalin Dizziness Pedal edema Weight gain
  Somnolence Creatine kinase elevation  
  Incoordination Decrease platelets  
  Dry mouth    
  Blurred vision    
Primidone Behavior changes Blood dyscrasias Behavior change
  Headache Rash Connective tissue disorders
  Nausea   Cognitive impairment
  Sedation   Sedation
  Unsteadiness    
Rufinamide Dizziness Multiorgan hypersensitivity Not established
  Nausea Status epilepticus  
  Vomiting Leukopenia  
  Somnolence QT shortening  
Tiagabine Dizziness Spike-wave stupor Not established
  Fatigue    
  Difficulties concentrating    
  Nervousness    
  Tremor    
  Blurred vision    
  Depression    
  Weakness    
Topiramate Difficulties concentrating Metabolic acidosis Kidney stones
  Psychomotor slowing Acute angle glaucoma Weight loss
  Speech or language problems Oligohydrosis  
  Somnolence, fatigue    
  Dizziness    
  Headache    
Valproic acid

GI upset

Sedation

Unsteadiness

Tremor

Thrombocytopenia

Acute hepatic failure

Acute pancreatitis

Alopecia

Polycystic ovary-like syndrome (increase incidence in females <20 y or overweight)

Weight gain

Hyperammonemia

Menstrual cycle irregularities

Vigabatrin

Permanent vision loss

Fatigue

Somnolence

Weight gain

Tremor

Blurred vision

Abnormal MRI brain signal changes (infants with infantile spasms)

Peripheral neuropathy

Anemia

Permanent vision loss (greater frequency, adults vs children vs infants)
Zonisamide Sedation Rash (is a sulfa drug) Kidney stones
  Dizziness Metabolic acidosis Weight loss
  Cognitive impairment Oligohydrosis  
  Nausea    

Reproduced with permission from Rogers SJ, Cavazos JE. Rogers S.J., Cavazos J.E. Epilepsy. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey L. DiPiro J.T., Talbert R.L., Yee G.C., Matzke G.R., Wells B.G., Posey L eds. Pharmacotherapy: A Pathophysiologic Approach, 9e. New York: McGraw-Hill; 2014:chap 40.

Data from French et al, Leppi, Halford and Lapointe, Cada et al, Sabril [package insert], Onfi [package insert], and Potiga [package insert].

http://icnapedia.org/wiki/epilepsy/adverse-reactions-of-antiepileptic-drugs
APA Style
Adverse reactions of antiepileptic drugs. (n.d.). In ICNApedia. Retrieved April 27,2017 21:15:47 from http://icnapedia.org/wiki/epilepsy/adverse-reactions-of-antiepileptic-drugs
MLA Style
"Adverse reactions of antiepileptic drugs." ICNApedia: The Child Neurology Knowledge Environment, Inc. October 14, 2015. Web. April 27,2017 21:15:47
AMA Style
ICNApedia contributors. Adverse reactions of antiepileptic drugs. ICNApedia, The Child Neurology Knowledge Environment. October 14, 2015. Available at: http://icnapedia.org/wiki/epilepsy/adverse-reactions-of-antiepileptic-drugs.Accessed April 27,2017 21:15:47.

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