Table 4.

Classification and characteristics of AED-associated ADRs

ADR Type	Characteristics	Representative Drugs	Typical ADRs	Management Strategy	Remarks
Type A	Dose-dependent, predictable, related to drug action	Phenytoin, Carbamazepine	Drowsiness, ataxia, tremors, GI symptoms	Dose adjustment, slow titration, symptomatic management	Most common ADR type (~ 30%) [22]
Type B	Idiosyncratic, immune/genetic-related, unpredictable	Lamotrigine, Valproic acid	SJS/TEN, hepatotoxicity, aplastic anemia	Immediate drug discontinuation, antihistamines, supportive care	Genetic screening recommended (e.g., HLA-B*1502 for lamotrigine-related SJS) [23, 24]
Type C	Chronic cumulative effects, related to long-term use	Phenobarbital, Phenytoin	Osteoporosis, gingival hyperplasia, cognitive impairment	Long-term monitoring (bone density, cognition), calcium/Vitamin D supplementation	Higher risk in elderly patients [25]
Type D	Delayed toxicity (months to years), genetic or developmental impact	Valproic acid, Phenytoin	Teratogenicity, carcinogenicity, neurodevelopmental abnormalities	Avoid in pregnancy; enhanced fetal monitoring	Valproic acid poses a teratogenic risk of up to 10% [26]

ADR: Adverse Drug Reaction