Phenobarbital |
Potential use: Partial seizures (with or
without secondary generalization), generalized tonic-clonic seizures,
myoclonic seizures, febrile seizures, status epilepticus, neonatal
seizures |
Main side effects: Sedation, drowsiness,
hyperactivity, irritability, insomnia, depression, cognitive impairment,
allergic reactions, decreased bone density, hemorrhagic disease
of the newborn |
Phenytoin |
Potential use: Partial seizures (with or
without secondary generalization), generalized tonic-clonic seizures,
status epilepticus, neonatal seizures |
Main side effects: Dizziness, ataxia, nystagmus,
diplopia, allergic reactions, gingival hyperplasia, acne, hirsutism,
cerebellar atrophy, decreased bone density, hemorrhagic disease
of the newborn, teratogenicity |
Ethosuximide |
Potential use: Absence seizures, myoclonic
seizures, astatic seizures (drop attacks) |
Main side effects: Abdominal discomfort,
hiccups, headaches, sedation, drowsiness, insomnia, ataxia, behavioral
disturbances, irritability, depression, hallucinations, psychosis,
bone marrow suppression (rare) |
Carbamazepine |
Potential use: Partial seizures (with or
without secondary generalization), generalized tonic-clonic seizures |
Main side effects: Somnolence, dizziness,
ataxia, diplopia/blurred vision, leukopenia, allergic reactions,
decreased bone density, hemorrhagic disease of the newborn, teratogenicity,
hyponatremia |
Valproate |
Potential use: Partial seizures (with or
without secondary generalization), generalized tonic-clonic seizures,
absence seizures, Lennox-Gastaut syndrome, juvenile myoclonic epilepsy,
infantile spasms, neonatal seizures (hyperammonemia) |
Main side effects: Psychomotor slowing,
fatigue, dose-related tremor, transient hair loss, increased appetite,
weight gain, thrombocytopenia, increased bruising, hyperammonemia
(mostly asymptomatic), fatal hepatotoxicity, pancreatitis,* encephalopathy,
nocturnal enuresis, teratogenicity, polycystic ovary syndrome |
Felbamate |
Potential use: Partial seizures (with or
without secondary generalization), Lennox-Gastaut syndrome, absences,
juvenile myoclonic epilepsy, infantile spasms |
Main side effects: Aplastic anemia, liver
failure, anorexia, weight loss, insomnia |
Gabapentin |
Potential use: partial seizures (with or
without secondary generalization), benign rolandic epilepsy. Ineffective
against absence seizures† |
Main side effects: Dizziness, ataxia, lethargy,
behavioral problems, increased appetite, weight gain, nocturnal
enuresis, choreoathetosis, oculogyric crisis, opisthotonus, myoclonus,
muscle twitching |
Lamotrigine |
Potential use: Partial seizures (with or
without secondary generalization), generalized tonic-clonic seizures,‡ absences,§ myoclonic seizures, Lennox-Gastaut syndrome,∫ infantile
spasms |
Main side effects: Hypersensitivity reactions,
somnolence, dizziness, ataxia, diplopia, blurred vision, tics/tourettism |
Topiramate |
Potential use: Partial seizures (with or
without secondary generalization), generalized tonic-clonic seizures,
Lennox-Gastaut syndrome, juvenile myoclonic epilepsy,¶ infantile
spasms |
Main side effects: Psychomotor slowing,
fatigue, change in behavior, mood, impaired attention and cognition,
language impairment, slurred speech, decreased appetite, weight
loss, nephrolithiasis, paresthesias, metabolic acidosis, anhydrosis,
glaucoma |
Tiagabine |
Potential use: Partial seizures (with or
without secondary generalization) |
Main side effects: Fatigue/weakness,
dizziness, nervousness, tremor, difficulty with concentration/attention,
knees buckling, nonconvulsive status epilepticus |
Vigabatrin (VGB) |
Potential use: Partial seizures (with or
without secondary generalization), infantile spasms |
Main side effects: Fatigue, headache, drowsiness,
dizziness, ataxia, tremor, depression, weight gain and hyperactivity
in children, irreversible visual field constriction |
Oxcarbazepine |
Potential use: Partial seizures (with or
without secondary generalization) |
Main side effects: Central nervous system
(CNS) side effects similar to carbamazepine, allergic rash (25% cross-reactivity
to CBZ), hyponatremia (rare in children)# |
Levetiraectam |
Potential use: Partial seizures (with or
without secondary generalization), generalized tonic-clonic seizures
in idiopathic generalized epilepsies, myoclonic seizures in juvenile,
myoclonic epilepsy |
Main side effects: Mood changes, behavioral
problems in children, asthenia, drowsiness, unsteadiness, psychosis |
Zonisamide |
Potential use: partial seizures (with or
without secondary generalization), generalized tonic-clonic seizures,
progressive myoclonic epilepsy, absence seizures, infantile spasms,
Lennox-Gastaut syndrome |
Main side effects: Drowsiness, ataxia, anorexia,
weight loss, GI symptoms, mental slowing, nephrolithiasis, anhydrosis,
metabolic acidosis, rash |
Pregabalin |
Potential use: partial seizures (simple
and complex, with or without secondary generalization) |
Main side effects: Dizziness, somnolence,
difficulty with concentration, dry mouth, eripheral edema (especially
in the elderly), blurred vision, excessive weight gain, may increase
myoclonic seizures** |