Table 1.

Suspected Psychotropic Aspects of Antiepileptic Drugs

Drug Class and Theorized Mechanism	Medication	Possible Psychotropic Benefit	Possible Psychotropic Detriment
GABAergic drugs (enhancing inhibitory networks)			Associated with increased sedation: fatigue, depression, weight gain, antimanic
	Benzodiazepines	Antianxiety	Sedation
	Gabapentin	Antianxiety, improves social phobia, useful for chronic pain
	Phenobarbital		Depression
	Pregabalin	Antianxiety	Some reports of depression
	Tiagabine		Mood lability
	Vigabatrin		Hyperactivity
Antiglutamatergic drugs (reducing action of excitatory networks)			Associated with increased activation: insomnia, agitation, anxiety, racing thoughts
	Felbamate		Insomnia
	Lamotrigine	Mood stabilizer, moderate antidepressant effect	Activating
Mixed or multiple mechanisms			Variable patterns of effect
	Carbamazepine	Mood stabilizer, improves impulsivity and aggression
	Eslicarbazepine	Mood stabilizer
	Ethosuximide		Confusion
	Lacosamide	Mood stabilizer
	Levetiracetam	Improved mood	Irritability, more common in pediatrics
	Oxcarbazepine	Mood stabilizer
	Phenytoin	Decreased aggression in some cases	Agitation, depression
	Sodium valproate	Mood stabilizer, improves impulsivity and aggression	Irritability, especially in context of sedation
	Topiramate	Reduced impulsivity	Word-finding difficulties, cognitive slowing, reduced appetite
	Zonisamide	Improved mood	Some cases of psychosis, activation