Acetazolamide (Diamox) Expand Used to enhance certain other anticonvulsant drugs may also be used for menstrual related seizures and certain episodic disorders. Possible side effects: Weight loss, drowsiness, lack of appetite, pins and needles in hands and feet, depression, joint pains, thirst, increased urine output, headache, fatigue, irritability and dizziness.
Brivaracetam (Briviact) Expand Adjunctive therapy of focal seizures with or without secondary generalisation. Possible side effects: Aggression, anxiety, decreased appetite, constipation, cough, depression, dizziness, drowsiness, fatigue, increased risk of infection, insomnia, irritability, nausea, vertigo and vomiting.
Carbamazepine (Tegretol, Tegretol Retard) Expand Effective against generalised tonic-clonic and partial seizures. May worsen myoclonic and absence seizures. Ineffective against absences. Possible side effects: Blurred vision, double vision, unsteadiness and nausea may occur initially or if the dose it too high. Skin rash if allergic to carbamazepine. Dizziness and headaches.
Clobazam (Frisium) Expand Effective against generalised tonic-clonic and partial seizures, but tolerance develops in about one third of children. Possible side effects: Irritability, fatigue and depression. Drowsiness may occur although this medication is less sedating than clonazepam or diazepam.
Clonazepam (Rivotril) Expand Effective against absences, generalised tonic-clonic and partial seizures, myoclonic seizures, Lennox-Gastaut syndrome, infantile spasms and status epilepticus. Possible side effects: Sedation and drowsiness are fairly common although these may wear off and tolerance (decline in effectiveness with time) tends to develop. Fatigue, aggression and overactive restlessness. Increased respiratory tract secretions.
Diazepam (Stesolid, Diazepam Rectubes) Expand For emergency use only in status epilepticus. Possible side effects: Blurred vision, vertigo, amnesia, drowsiness and unsteadiness.
Ethosuximide (Emeside, Zarontin) Expand Only effective against generalised absences. Possible side effects: Drowsiness, nausea, headache.
Everolimus (Votubia) Expand Adjunctive treatment of refractory partial-onset seizures, with or without secondary generalisation, associated with tuberous sclerosis complex. Possible side effects include: Alopecia, anaemia, decreased appetite, cough, dry mouth, fever, headache, insomnia, nail disorders, nausea, renal impairment, vomiting, weight decrease.
Gabapentin (Neurontin) Expand Recommended for partial seizures, where previous treatment has been ineffective. May worsen myoclonic and/or absence seizures. Possible side effects: Dizziness, headache, double vision, fatigue, drowsiness, unsteadiness and shaky movements.
Lacosamide (Vimpat) Expand Add-on therapy for focal seizures with or without secondary generalisation. Possible side effects: Nausea, vomiting, constipation, wind, dizziness, headache, impaired coordination, drowsiness, tremor, depression, fatigue, abnormal walking, blurred vision, abnormal eye movements, and itching.
Lamotrigine (Lamictal) Expand Effective against Lennox-Gastaut syndrome, absence, partial and generalised tonic-clonic seizures. Possible side effects: Skin rash particularly if rapid dose increase, if allergic to lamotrigine. Double vision, dizziness, drowsiness, headache and flu-like symptoms, if the dose is too high. Possibly insomnia.
Levetiracetam (Keppra) Expand Currently not licensed for children under 16 years; refractory partial seizures. Possible side effects: Dizziness, nausea, behaviour change and sedation.
Nitrazepam Expand Infantile spasms. Possible side effects: Shaky movements, dependence, loss of memory, confusion, muscle weakness.
Oxcarbazepine (Trileptal) Expand Generalised and partial seizures. Possible side effects: Skin rash if allergic to oxcarbazepine. Headache, nausea, double vision, unsteadiness and confusion.
Perampanel (Fycompa) Expand Add-on therapy for focal seizures with or without secondary generalisation. Possible side effects: Dizziness, sleepiness, loss of or increased appetite, aggression, anger, anxiety, confusion, unsteadiness, speech difficulties, balance disorder, irritability, blurred or double vision, vertigo, nausea, back pain, walking difficulty, fatigue, weight gain, and risk of falling. Report severe reactions, such as a skin rash, to your doctor.
Phenobarbital Expand Effective against generalised partial and tonic-clonic seizures. Neonatal seizures and status epilepticus. Possible side effects: Drowsiness may occur initially, sedation and slowing of mental performance may persist. Listlessness, depression, fatigue, rash, tiredness, insomnia and irritability. Hyperactivity, aggression and subtle impairment of mood, memory and learning capacity.
Phenytoin (Epanutin) Expand Effective against partial and generalised tonic-clonic seizures. Status epilepticus. Blood testing is essential when using phenytoin as the relationship between dose and blood level is complex. Possible side effects: Skin rash if allergic to phenytoin. Unsteadiness, drowsiness and slurred speech may occur if too high a dose is used. Coarsening of facial features, overgrowth of gums, acne and growth of excess hair may be problems with prolonged therapy, as can some anaemias (treated with folic acid). Unsteady gait, shaky movements, sedation and rapid involuntary movement of the eye.
Piracetum (Nootropil) Expand Adjunctive treatment of cortical myoclonus. Possible side effects: Anxiety, epilepsy exacerbated, hallucination, headache, movement disorders, weight increase, vertigo.
Pregabalin (Alzain, Axalid, Lecaent, Lyrica, Rewisca) Expand Adjunctive therapy for focal seizures with or without secondary generalisation. Not recommended if tonic, atonic, absence or myoclonic seizures are present. Possible side effects: Infection, ataxia, blurred vision, constipation, double vision, dizziness, drowsiness, fatigue, headache, peripheral edema, tremor, weight gain, visual field loss, accidental injury and xerostomia (dry mouth).
Primidone (Mysoline) Expand Effective against partial and generalised tonic-clonic seizures. Possible side effects: Tiredness, depression, listlessness, fatigue, psychosis, overactive restlessness and irritability.
Rufinamide (Inovelon) Expand Used in combination with other medication and therapy to treat Lennox-Gastaut Syndrome and various other seizure disorders. Possible side effects: Seizures, dizziness, drowsiness, fatigue, headache, nausea, vomiting, status epileticus, ataxia, blurred vision, diplopia (double vision) and skin rash.
Sodium Valproate (Epilim, Epilim Chrono) Expand Effective against absences and generalised tonic-clonic and partial seizures. Possible side effects: Weight gain may occur with increased appetite. Hair loss occurs in some people but this is not usually severe and is usually reversible if the dosage is reduced. Gastric problems, hyperactivity and behaviour problems. Long term use of Sodium Valproate may cause carnitine deficiency. The use of sodium valproate has been associated with increased incidence of polycystic ovaries and menstrual irregularities but needs to be evaluated further. Shaky movements and drowsiness are infrequent side effects. Some liquid versions of Sodium Valproate contain colourings that may cause insomnia. We felt this worth mentioning as it's a topic which has been brought to the attention of The Daisy Garland by a number of families we support whose children became restless and unable to sleep. This was remedied by a change in brand. If you have any concerns at all about food colourings/Sodium Valproate please discuss with your Neurologist. WARNING FOR WOMEN AND GIRLS Sodium Valproate can seriously harm an unborn baby. Always use effective contraception during treatment. If you are thinking about becoming pregnant, or you become pregnant, talk to your doctor straightaway. WARNING From January 2024 Sodium Valproate must not be started in new patients aged under 55 unless two specialists agree that there are no alternative options or that “compelling reasons” mean that the reproductive risks “do not apply,”. https://www.bmj.com/content/383/bmj.p2836.full
Stiripentol Expand Improves the effectiveness of many other anticonvulsants and is indicated as an adjunctive therapy with sodium valproate and clobazam for treating severe myoclonic epilepsy in infancy (SMEI, also know as Dravet syndrome). Possible side effects: Nausea and vomiting are particularly noted when used in combination with sodium valproate.
Tiagabine (Gabitril) Expand May make myoclonic seizures worse. Recommended for partial seizures when previous treatment has been ineffective. Possible side effects: Tremor, concentration difficulties, dizziness, anxiety, depression, fatigue, agitation and jerkiness of limbs.
Topiramate (Topamax) Expand Effective against severe myoclonic epilepsy in infancy. For children over 2 years of age. Recommended in partial and generalised seizures. Possible side effects: Pins and needles in hands and feet and loss of weight, headache, drowsiness. Increased risk of kidney stones. Slowing of mental performance and language may occur but minimised if dose started low and increased slowly. Cases of eye reactions have rarely been associated with topiramate occurring within one month of commencement of treatment.
Vigabatrin (Sabril) Expand First line for infantile spasms. May worsen absences and myoclonic seizures. May be considered for resistant partial seizures if visual fields can be monitored. Possible side effects: Behaviour and mood changes, drowsiness, nausea. Visual field defects have been reported in one in three adults taking this drug in the long term. While taking vigabatrin visual fields should be measured every six months. Psychotic reactions have been reported.
Zonisamide (Zonegran) Expand Used together with other anticonvulsant medications to treat partial seizures. Possible side effects: Skin rash, breathing difficulties, swelling of face, lips, tongue or throat, anxiety, behaviour changes, insomnia, drowsiness, panic attacks, hyperactivity, depression. Also rapid heart rate, flu symptoms, loss of appetite, loss of balance or co-ordination and dizziness.