Drug Use Don’t use Mechanism Toxicity Other

Phenytoin (Dilantin) Secondary in Status Absence Targets Na channels Ataxia, nystagmus, Small margin of
Epilepticus cognitive safety,
impairment concentration-based
elimination
Carbamazepine Partial complex Absence Blocks NA channels, Autoinduction of Tricyclic
(Tegretol) inhibits high metabolism, nausea, antidepressant
frequency firing visual problems, analog, active
Aplastic anemia metabolite
Oxcarbazepine “ “ Inhibits repetitive Hyponatremia (low Analog of
(Trileptal) firing and Na channel Na) carbemazapine w/o
conductance toxic metabolite
Phenobarbital Partial, generalized Absence and atonic Prolongs GABA Cl Sedation, cognitive Infants, “oldest and
(Luminal) tonic-clonic, febrile channel opening impairment, liver safest AED”
(infant) enzyme induction
Primidone (Mysolin) Partial and “ “ “ Metabolized into
generalized tonic- phenobarbital and
clonic
Diazepam (Valium) Status epilepticus Increases frequency Sedation, kids can Ativan is primary in
and Lorazepam of GABA Cl channel have increased status epilepticus
(Ativan) opening hyperactivity,
tolerance
Clonazepam Absence, myoclonic “ Sedation, ataxia Long acting
(Klonopin)
Valproate Tonic-clonic, Be careful w/ other Inhibits Na channels, Induction of liver
(Depakene) absence, and AED’s Inhibits GABA enzymes and
myoclonic metabolism (GABA metabolism, nausea,
transaminase and vomiting, tummy
semialdehyde pain, tremor, hair
dehydrogenase) to loss, weight gain,
Hepatotoxicity,
 increase GABA, Teratogen, adverse
inhibits HDAC effects with other
AED’s
Vigabatrin (y-Vinyl- Partial Pre-existing mental Irreversible inhibitor Drowsiness,
GABA) illness of GABA dizziness, weight
transaminase gain, confusion,
psychosis
Tiagabine (Gabatril) Adjunctive for partial GABA uptake Dizziness, tremor, Doesn’t affect other
and generalized inhibitor decreased AED’s
tonic-clonic concentration,
asthenia, emotional
changes, skin rash
Lamotrigine Broad spectrum, Suppress sustained Dizziness, headache, Use with valproate,
(lamictol) primary generalized, rapid firing, use- diplopia, nausea, good cognitive and
adjunctive for partial dependent Na somnolence, skin behavioral profile
+/- secondary channel inactivator rash
generalized, (like local
effective in patients anesthetics)
with depression
Ethosuximide Absence Reducing low GI distress, lethargy,
(Zarontin) threshold Ca channel headache, hiccups,
current in thalamus skin rash
Zonisamide Generalized and Inhibit v-gated Na Drowsiness,
(Zonegran) partial, adjunctive channels and T-type cognitive
against partial and Ca channels impairment, skin
myoclonic rash, weight loss,
kidney stones
Felbamate (Felbatol) Partial and Most of the time do Inhibit Na channels Aplastic anemia and Danger
generalized, only use not use this drug and NMDA hepatic failure
for refractory receptors, potentiate
(stubborn seizures) GABA
Topiramate Adjunctive for partial V-gated Na channel Somnolence,
(Topamax) and generalized blocker, glut dizziness, cognitive
tonic-clonic receptor antagonist, slowing, change in
potentiate GABA verbal fluency,
decreased appetite
Gabapentin Adjunctive therapy High efficiency Somnolence, Very safe
(Neurontin) for partial +/- binding to a2d Ca dizziness, ataxia,
secondary channels weight gain,
generalized behavioral changes
Pregabalin (Lyrica) “ Low dose tx, good
for use in chronic
pain
Levitiracetam Adjunctive adult Targets synaptic Somnolence, Wide margin of
(Keppra) and partial vesicle protein 2A asthenia, behavioral safety
Brivaracetam changes, headache