AED Specific Adverse Effects

Older AEDs

• CBZ, OXC:  Leukopenia, Hyponatremia, Peripheral Neuropathy
• CZP:  Increased Secretions
• ESM:  GI Upset, HA
• PB, PRM:  Cognitive Dysfunction, Dupytren's Contracture
• PHT: Hirsutism, Gingival hypertrophy, Peripheral Neuropathy, Folate Deficiency, Osteomalacia
• VPA: Hepatotoxicity (esp. <2yrs old), Tremor, Hair Loss, Weight Gain, Thrombocytopenia, Hyperammonemia

AED Specific Adverse Effects

Newer AEDs

• FBM: Weight Loss, Aplastic Anemia (esp. female), Liver Failure
• GBP: Peripheral Edema
• LTG: Skin Rash (esp with VPA)
  
• LEV: Behavior Problems, HA
• TGB: Stupor (Spike Wave Stupor)
• TPM: Cognition, Renal Stones (esp. w/ ketogenic diet), Hypohidrosis, Wt loss, Open angle glaucoma
• ZNS: Rash (esp. w/ sulfa allergy), wt loss, Renal stones, HA
• VGB: Visual Impairment
  

Best initial choice for simple or complex partial Sz.

Adverse Effects: 

Bone marrow Suppression (with granulocytopenia)

Hyponatremia (due to SIADH)

VPA and LTG

Depakote and Lamotrigine are notorious for interacting

Partial Seizures, secondarily generalized TC Sz and the multiple generalized sz types of Lennox-Gastaut

Adverse Effects:

Fatal Aplastic Anemia

Hepatotoxicity

ONLY for refractory Sz when potential benefits outweigh the risks

May be best inital choice for some primary generalized epilepsies, such as Childhood Absence Epilepsy and Primary Generalized Tonic-Clonic Seizures

Adverse Effects:

Cosmetic Changes (Wt gain and Hirsutism)

Polycystic Ovary Disease

Pancreatitis

Rare but serious Hepatotoxicity