What Are the Side Effects Of Epilepsy Medications?

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Epilepsy, also known as a seizure disorder is a condition characterized by a predisposition to having seizures. If you have been diagnosed with epilepsy or with a seizure disorder of any cause, you might need to take one or more epilepsy medications (anti-seizure medications) to reduce your chances of having a seizure.

Anti-seizure medications are medications that have a chemical effect on the brain to inhibit seizures.

They are also called anticonvulsants, and they are only available by prescription because they are powerful medications.

There are about 30 different anticonvulsants available. The different anticonvulsants have characteristic pharmacological actions that make some of them more suitable for managing your particular seizure disorder than others. Most anticonvulsants are well tolerated and effective, but they may produce side effects. If you are taking one or more anticonvulsants, it is useful to become familiar with the side effects so that you will recognize them if you experience any of them.

Common Anticonvulsants: Uses & Side Effects

Levetriacetam is commonly known by the brand name Keppra. It is one of the more commonly used anticonvulsants for children and adults and it is generally used in combination with one or more anticonvulsants.

Common side effects include tiredness, dizziness, depression, irritability and infection.

Rarely, it can be associated with serious complications such as decreased blood cells, psychosis and with Steven Johnson syndrome. This is an uncommon disorder characterized by flu-like symptoms and severe sloughing of the skin, potentially causing a fatal infection or fatal dehydration.

Phenytoin is one of the oldest anticonvulsant medications and is often known by the brand name Dilantin.

It can be used alone or in combination with other anticonvulsants for seizure control in  children and adults.

Side effects include dizziness, tiredness, difficulty concentrating, double vision, and gingival hypertrophy (enlargement of the gums).

Less commonly, serious problems such as decreased blood cells, liver failure, and Steven Johnson syndrome can occur.

Carbamazepine is known by the brand names Tegretol and Carbatrol. It can be used alone or in combination with other anticonvulsants for the control of seizures in children and adults. Carbamazepine is also often used for the treatment of pain that is related to conditions such as neuropathy and trigeminal neuralgia.

Tegretol can cause dizziness, blurry or double vision a skin rash. The skin rash may progress and become severe, and even potentially fatal. Carbamazepine  can also cause nausea, vomiting, diarrhea, and decreased sodium levels. Infrequently, severe decrease in one of the white blood cells, called neutrophils, severe anemia, liver failure, and Steven-Johnson syndrome can occur.

Valproic acid is generally known by the brand name Depakote. It can be used alone or in combination with other anticonvulsants for children and adults.

Valproic acid is often used for the management of seizures that are associated with childhood developmental   conditions such as Juvenile Myoclonic Epilepsy and Lennox-Gastaut Syndrome  as well as with petit mal or absence seizures.

Common side effects include dizziness, fatigue, tremors, stomach upset, hair loss, weight gain and easy bruising. Rarely, liver failure  and menstrual irregularities can occur. Birth defects can result in children of women who take valproic acid during pregnancy

Gabapentin is known by the brand name Neurontin. This is an add-on medication for epilepsy. Gabapentin is also often used for prevention of painful conditions, such as neuropathic pain and headaches.

Side effects include tiredness and dizziness.

Phenobarbital is one of the oldest and most well understood anticonvulsants. Phenobarbital can be used alone or in combination with other anticonvulsants for children and adults.

Side effects include dizziness, tiredness, trouble concentrating and slurred speech.

Primidone is known by the brand name Mysoline. It is typically used for seizure control in children. Another use of Primidone is for the treatment of a condition called Benign Essential Tremor, which is characterized by tremors and shaking of the hands, particularly in times of stress.

Side effects include loss of balance, unsteadiness, tiredness, nystagmus (jerky eye movements) and vomiting.

Topiramate is an anticonvulsant known by the brand name Topamax. Topiramate is generally used in combination with other anticonvulsants for the treatment of partial seizures in children and adults. Sometimes, Topiramate is used to prevent migraine pain or neuropathic pain.

Side effects include irritability, difficulty concentrating. weight loss and tingling.

Rarely, serious side effects such as glaucoma, kidney stones and very high fevers (mostly in children) can occur.

Oxcarbazepine is known by the brand name Trileptal. It can be used alone or in combination with other medications and it is sometimes used to treat pain as well.

Side effects include dizziness, drowsiness, dry mouth, constipation and blurred vision.

Like carbamazepine, rarely it can cause low blood counts and a severe skin rash.

Tiagabine is known by the brand name Gabitril. It is used for seizure control for adults and older children.

Side effects include dizziness, sedation, balance problems, difficulties with concentration and abdominal pain. Less commonly, it can cause itching and blistering of the skin.

Lamotrigine is known by the brand name Lamictal. It is used for seizure control in adults and it is considered one of the anticonvulsants used for difficult to manage childhood epilepsy. It is also used for the management of bipolar disorder (a disorder characterized by episodes of depression as well as episodes of mania.)

Side effects include dizziness, double vision, tremors , nausea and rash. Steven Johnson syndrome can occur, but rarely

Ethosuximide is known by the brand name Zarontin. It is used for the treatment of a specific kind of seizure called a Petit Mal seizure or an Absence seizure. This type of seizure is characterized by blanking out, or staring into space, rather than by involuntary movements of the body.

Side effects include drowsiness, headaches, dizziness, irritability, decreased appetite and rarely low white blood cell count.

Zosinamide, known by the brand name Zonegran, is typically used in combination with another anticonvulsant.

Side effects include dizziness, drowsiness, confusion, depression, nausea and lack of appetite.  Rash, fevers, decrease in blood counts and kidney stones can occur.  

Clobazam is known by the brand name Onfi. It is a sedative and an anticonvulsant and can be used for treatment of severe childhood epilepsy.

Side effects include drowsiness, dizziness, irritability and hallucinations.

Clonazepam is known by the brand name Klonopin. It is a sedative that may be used along with anticonvulsants to treat seizures, particularly childhood seizures.

Side effects include drowsiness, confusion, depression and itching.

Emergency Anticonvulsants

Some medications that are not prescribed for seizure prevention may be used during an emergency situation. If you have had to go to the hospital for severe seizures or for seizures that did not stop easily, it is possible that you would see in your chart that you were given Lorazepam, brand name Ativan or Diazepam, brand name Valium. These medications can quickly bring seizures to a stop, and side effects include dizziness, tiredness, confusion and slurred speech. These medications are not recommended for regular use or for seizure prevention.

A Word From Verywell

Anticonvulsants interact with the neurons in the brain to slow down activity, but they all have somewhat different ways of preventing seizures. In general, it is unsafe to drink alcohol or to use drugs if you need an anticonvulsant.

If you experience any of the side effects, you should get medical attention. It is unsafe to stop any anticonvulsant abruptly or on your own. You should follow your doctor’s instructions when starting or stopping any anticonvulsant.

If you are taking an anticonvulsant and if you plan to become pregnant or if you accidentally become pregnant, you must let your medical team know right away, as many anticonvulsants can be associated with birth defects.

Sources:

Weston J, et al. Monotherapy treatment of epilepsy in pregnancy: congenital malformation outcomes in the child. Cochrane Database Syst Rev. 2016 Nov 7;11:CD010224.

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