Table 2. Representative adverse effects and contraindications of AEDs.
| AED | Adverse effects | Contraindications and adverse effects that require AED cessation |
|---|---|---|
| Carbamazepine* | Neurological: somnolence, lethargy, dizziness, diplopia, ataxia | SJS, DRESS, bone-marrow suppression, AVB, MAOI medication |
| General: hyponatremia, GI problems, leukocytopenia, LFT elevation, rash, osteoporosis | ||
| Ethosuximide | Neurological: somnolence, dizziness, ataxia, anorexia, psychosis | SJS, DRESS, pancytopenia, lupus, porphyria |
| General: GI problems, weight loss, leukocytopenia, anemia | ||
| Gabapentin* | Neurological: somnolence, lethargy, dizziness, diplopia, ataxia, tremor | Pancreatitis, absence seizure |
| General: GI problems, weight gain | ||
| Lacosamide* | Neurological: somnolence, lethargy, dizziness, diplopia, ataxia, headache | |
| General: cardiac arrhythmia | ||
| Lamotrigine* | Neurological: ataxia, dizziness, diplopia, aseptic meningitis | SJS, DRESS |
| General: rash, osteoporosis | ||
| Levetiracetam | Neurological: somnolence, lethargy, dizziness, diplopia, ataxia, mood disorders, psychosis | Suicidal ideation, pancytopenia |
| Oxcarbazepine* | Neurological: somnolence, lethargy, dizziness, ataxia, headache | SJS, AVB, bone-marrow suppression, MAOI medication |
| General: hyponatremia, GI problems | ||
| Perampanel* | Neurological: somnolence, lethargy, dizziness, diplopia, ataxia, falling, hostility, psychosis, mood disorder | Suicidal or homicidal ideation |
| Phenobarbital* | Neurological: somnolence, lethargy, dizziness, diplopia, ataxia, headache, rash, psychosis, mood disorder, cognitive slowing | SJS, DRESS |
| General: osteoporosis, anemia | ||
| Phenytoin* | Neurological: somnolence, lethargy, dizziness, diplopia, ataxia, nystagmus, cerebellar atrophy | SJS, bone-marrow suppression, recent myocardial infarction, second- or thirddegree AVB |
| General: gingival hypertrophy, osteoporosis, pancytopenia, lymphadenopathy | ||
| Pregabalin | Neurological: somnolence, lethargy, dizziness, ataxia | Angioedema |
| General: dry mouth, weight gain, edema | ||
| Topiramate* | Neurological: cognitive slowing, dizziness, anorexia | Glaucoma, hyperammonemia, hypohidrosis with hyperthermia, urolithiasis |
| General: weight loss, GI problems | ||
| Valproic acid* | Neurological: dizziness, diplopia, ataxia, tremor | Urea-cycle disorder, unfulfilled PPP, significant hepatic or pancreatic dysfunction, porphyria, coadministration with carbapenems or mefloquine |
| General: hyperammonemia, thrombocytopenia, alopecia, GI problems, weight gain | ||
| Vigabatrin | Neurological: somnolence, lethargy, diplopia, ataxia, nystagmus, cognitive slowing | Permanent bilateral visual field constriction, blurred vision |
| General: anemia, weight gain, arthralgia | ||
| Zonisamide* | Neurological: somnolence, lethargy, dizziness, ataxia, mood disorders, anorexia, cognitive slowing | SJS, DRESS, urolithiasis, hypohidrosis with hyperthermia |
| General: weight loss |
*Contraindicated in galactose intolerance, Lapp lactose deficiency, and glucose/galactose malabsorption.
AED: antiepileptic drug, AVB: atrioventricular block, DRESS: drug reaction with eosinophilia and systemic symptoms, GI: gastrointestinal, LFT: liver function test, MAOI: monoamine oxidase inhibitor, PPP: pregnancy prevention program, SJS: Stevens-Johnson syndrome.