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Common and/or important side-effects of anti-epileptic drugs

CARBAMAZEPINE (Tegretol, Teril Carbamazepine, Sandoz) - Drowsiness, fatigue, dizziness, ataxia, diplopia, blurring of vision, sedation, headache, insomnia, gastrointestinal disturbance, tremor, weight gain, impotence, effects on behaviour and mood, hepatic disturbance, rash and other skin reactions, bone marrow dyscrasia, leucopenia, hyponatraemia, water retention, endocrine effects

CLOBAZAM (Frisium) - Sedation (common and may be severe), cognitive effects, drowsiness, ataxia, personality and behavioural changes, hyperactivity, restlessness, aggressiveness, psychotic reaction, seizure exacerbations, hypersalivation, muscle tone changes, leucopenia, withdrawal symptoms

CLONAZEPAM (Rivotril Paxam) - Sedation (common and may be severe), cognitive effects, drowsiness, ataxia, personality and behavioural changes, hyperactivity, restlessness, aggressiveness, psychotic reaction, seizure exacerbations, hypersalivation, muscle tone changes, leucopenia, withdrawal symptoms

ETHOSUXIMIDE (Zarontin) - Gastrointestinal symptoms, drowsiness, ataxia, diplopia, headache, dizziness, hiccups, sedation, behavioural disturbances, acute psychotic reactions, extrapyramidal symptoms, blood dyscrasia, rash, lupus-like syndrome, severe idiosyncratic reactions

GABAPENTIN (Gabatine, Neurontin Nupentin, Gantin DBL Gabapentin Gabapentin Sandoz or Pfizer or GA or GenRx (Gabahexal), (Pendine)) - Drowsiness, dizziness, seizure exacerbation, ataxia, headache, tremor, diplopia, nausea, vomiting, rhinitis

LACOSAMIDE (Vimpat) - Vertigo, Diplopia, Blurred vision, Nausea, Vomiting, constipation, Flatulence, Fatigue, Gait disturbance, Asthenia, Dizziness, headache, Abnormal co-ordination, somnolence, tremor, nystagmus, balance disorder, memory impairment, cognitive disorder, depression, pruritus.

LAMOTRIGINE (Lamictal, Seaze Lamogine, Lamotrust Lamidus, Reedos Torlemo Lamotrigine, Aspen or Sandoz or Generichealth or GA or GenRx or APO) - Rash (sometimes severe), Stevens-Johnson syndrome headache, blood dyscrasia, ataxia, asthenia, diplopia, nausea, vomiting, dizziness, somnolence, insomnia, depression, psychosis, tremor, hypersensitivity reactions

LEVETIRACETAM (Keppra, Kepcet Kerron, Kevtam Levecetam Lemitaccord Lemitam Levetiracetam APO) - Somnolence, asthenia, infection, dizziness, headache, irritability, aggression, behavioural and mood changes, suicidal thoughts

OXCARBAZEPINE (Trileptal) - Somnolence, headache, dizziness, diplopia, ataxia, rash, hyponatraemia, weight gain, alopecia, nausea, gastrointestinal disturbance

PHENOBARBITONE - Sedation, ataxia, dizziness, insomnia, hyperkinesis (children), mood changes (especially depression), aggressiveness, cognitive dysfunction, impotence, reduced libido, folate deficiency, vitamin K and vitamin D deficiency, osteomalacia, Dupuytren contracture, frozen shoulder, connective tissue abnormalities, rash. Risk of dependency. Potential for abuse

PHENYTOIN (Dilantin) - Ataxia, dizziness, lethargy, sedation, headaches, dyskinesia, acute encephalopathy (phenytoin intoxication), hypersensitivity, rash , fever, blood dyscrasia, gingival hyperplasia, folate deficiency, megaloblastic anaemia, vitamin K deficiency, thyroid dysfunction, decreased immunoglobulins, mood changes, depression, coarsened facies, hirsutism, peripheral neuropathy, osteomalacia, hypocalcaemia, hormonal dysfunction, loss of libido, connective tissue alterations, pseudolymphoma, hepatitis, vasculitis, myopathy, coagulation defects, bone marrow hypoplasia

PREGABALIN (Lyrica) - Somnolence, dizziness, ataxia, asthenia, weight gain, blurred vision, diplopia, tremor

PRIMIDONE (Mysoline) As for phenobarbital. Also dizziness and nausea on initiation of therapy

TIAGABINE (Gabitril) - Dizziness, tiredness, nervousness, tremor, diarrhoea, nausea, headache, confusion, psychosis, flu-like symptoms, ataxia, depression, word-finding difficulties, encephalopathy, non-convulsive status epilepticus

TOPIRAMATE (Topamax, Tamate Epiramax Topiramate APO or Sandoz or GA or RBX) - Dizziness, ataxia, headache, paraesthesia, tremor, somnolence, cognitive dysfunction, confusion, agitation, amnesia, depression, emotional lability, nausea, diarrhoea, diplopia, weight loss, kidney stones

VALPROATE (Epilim, Valpro Sodium Valproate Sandoz, Valprease Valproate Winthrop EC) - Nausea, vomiting, hyperammonaemia and other metabolic effects, endocrine effects, severe hepatic toxicity, pancreatitis, drowsiness, cognitive disturbance, aggressiveness, tremor, weakness, encephalopathy, thrombocytopenia, neutropenia, aplastic anaemia, hair thinning and hair loss, weight gain, polycystic ovarian syndrome

VIGABATRIN (Sabril) - Mood change, depression, psychosis, aggression, confusion, weight gain, insomnia, changes in muscle tone in children, tremor, diplopia, severe visual field constriction

ZONISAMIDE (Zonegran) - Somnolence, ataxia, dizziness, fatigue, nausea, vomiting, irritability, anorexia, impaired concentration, mental slowing, itching, diplopia, insomnia, abdominal pain, depression, skin rashes, hypersensitivity. Significant risk of renal calculi. Weight loss, oligohidrosis and risk of heat stroke

Source: S D Shorvon, Handbook of Epilepsy Treatment: Forms, Causes and Therapy in Children and Adults, 2nd edn, Blackwell, Carlton, 2005.

Brand names have been added. Source: PBS, Pharmaceutical Benefits Schedule, reviewed 25 August 2013, http://www.pbs.gov.au.

Information reviewed by Dr. Dan McLaughlin, Brisbane.

Updated August 2013 To be reviewed August 2015

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