Table 3.
Advantages and disadvantages of each AED
| AED | Advantage | Disadvantage |
|---|---|---|
| Phenobarbital | Powerful antiepileptic | Marked cognitive effects Osteoporosis |
| Possibility of parenteral administration | Many pharmacological interactions | |
| Phenytoin | Powerful antiepileptic | Absorption affected by food or antacids |
| Possibility of parenteral administration | High bonding to proteins (80%–95%) | |
| Complex, non linear kinetics | ||
| Rapid titration | Enzymatic inducer. Inducible | |
| Does not affect weight | Osteoporosis | |
| Valproic acid | Powerful antiepileptic | High bonding to proteins (80%–95%) |
| Possibility of parenteral administration | Enzymatic inhibitor | |
| Weight gain (>50%) | ||
| Minimum cognitive effects | Osteoporosis | |
| Tremor | ||
| Thrombopenia | ||
| Carbamazepine | Powerful antiepileptic | High bonding to proteins (80%) |
| Minimum cognitive effects | Hepatic metabolism | |
| Enzymatic inducer. Auto-induction | ||
| Osteoporosis | ||
| Weight gain | ||
| Hyponatremia | ||
| Alterations to heart conduction system | ||
| Slow titration | ||
| Allergic reaction | ||
| Oxcarbazepine | Powerful antiepileptic | Slight hepatic inducer |
| Linear kinetics | Bonds to proteins (67%) | |
| No cognitive effects | Hyponatremia | |
| Does not affect weight | Alteration to heart conduction system | |
| Topiramate | Powerful antiepileptic | Cognitive disorder |
| Does not bond to proteins | Slight hepatic inducer Inducible | |
| Renal lithiasis | ||
| Metabolic acidosis | ||
| Slow titration | ||
| Lamotrigine | Powerful antiepileptic | Hepatic metabolism |
| Linear kinetics | Slight hepatic inducer Very inducible | |
| No cognitive effects | Bonds to proteins (55%–60%) | |
| Does not affect weight | Allergic reactions | |
| Slow titration | ||
| Tiagabin | Weak antiepileptic | |
| Three doses | ||
| High bonding to proteins (96%) | ||
| Hepatic metabolism Inducible | ||
| Somnolence | ||
| Gabapentin | Rapid titration | Weak antiepileptic |
| No hepatic metabolism | Three doses | |
| Does not bond to proteins | Saturable absorption | |
| No interactions | Weight gain | |
| Pregabalin | Powerful antiepileptic | Somnolence |
| Rapid titration | Weight gain | |
| Rapid absorption not saturable | ||
| No hepatic metabolism | ||
| Does not bond to proteins | ||
| No interactions | ||
| Levetiracetam | Powerful antiepileptic | Uncommon irritability and psychiatric disorders (<7%) |
| Rapid titration | ||
| No hepatic metabolism | ||
| Does not bond to proteins | ||
| No interactions | ||
| No cognitive alteration |