Common Epilepsy Medications

All medications have the possibility of causing side effects. There are three main types of anti-epileptic medication side effects.

  • Some mild side effects are common when starting anti-epileptic medications, particularly if the dose is increased rapidly. These include nausea, abdominal pain, dizziness, sleepiness, irritability, anxiety or mood changes. These are usually not serious, but may worry some people and should be discussed with your doctor or pharmacist. Your doctor may slow the rate at which the medication is being introduced or may cut back another anti-epileptic medication with which it may be interacting.
  • Some side effects are common to anti epileptic medications when prescribed at too great a dose and are similar to being “drunk” eg. unsteadiness, poor concentration, sleepiness, double vision, vomiting, tremor. It is important to report these side effects to your doctor immediately if they occur.
  • Some side effects are peculiar to individual medications and only occur in some people eg. rash, blood problems, liver problems, severe behaviour disturbance, worsening of seizure control. There are some patients or situations in which there may be increased risk of such side effects with a certain medication.

Please refer to the specific drug information provided with your medication for a more detailed list of side effects.  As numerous side effects are listed against all medications, your doctor should help you understand which are the more common or potentially serious side effects to look out for.  It is important to contact your doctor if you are worried about these or other side effects.

Focal Seizures:- Carbamazepine, clobazam, lamotrigine, levetiracetam, oxcarbazepine, sodium valproate, topiramate

General Tonic Clonic Seizures:- Carbamazepine, clobazam, lamotrigine, levetiracetam, phenytoin, sodium valproate,  topiramate

Absence Seizures:- Ethosuximide, lamotrigine, sodium valproate

Myoclonic Tonic and Atonic Seizures:- Clobazam, clonazepam,  lamotrigine, levetiracetam, sodium valproate, topiramate

Infantile Spasms:- ACTH, nitrazepam,  prednisolone,  vigabatrin

Neonatal Seizures:- Phenobarbitone, phenytoin, clonazepam

Epilepsy Medication Side Effects

This list is provided as a reference for those who looking up specific side effects of medications. Its purpose is not to diagnose nor to tell you what drug would accurately help your own or your child’s seizure condition. Additionally the side effects listed may generally not occur when you or your child take the medication. This is based on the drug manufacturers known side effects of their medications from their medical trials.

Only your neurologist can and should be considering which drug is appropriate in helping to treat your or your child’s seizure condition.

Keppra (levetiracetam) Well we all know about “Keppra Rage” but here, too, is a list of common Keppra side effects — dizziness; drowsiness; irritability; sore throat; tiredness; weakness. Not to mention abnormal thoughts, decreased coordination, extreme dizziness, drowsiness, tiredness, or weakness; hallucinations, memory loss, muscle or neck pain; new or worsening mental, mood, or behavior changes (eg, aggression, agitation, anger, anxiety, apathy, depression, hostility, irritability, panic attacks, restlessness); new or worsening seizures; suicidal thoughts or attempts.

Dilantin (phenytoin) – moderate cognitive problems, slurred speech, confusion, hallucinations, mood or behavior changes, hyperactivity (mentally or physically), unsteadiness, dizziness, fatigue, gum overgrowth, potential  body/face hair growth, skin problems, bone problems (osteoporosis), suicide thoughts or attempts. Plus, Dilantin can cause a rare and dangerous rash called Stevens-Johnson Syndrome.

Ativan (lorazepam) — drowsiness, sleepiness, fatigue, poor coordination, unsteadiness, behavior changes.

Banzel (rufinamide) – loss of appetite, vomiting, dizziness, headache, fatigue, irritability, attention difficulty, double vision, itchiness, stomach pain. People who have a heart rhythm irregularity, should not take Banzel.

Carbatrol (extended release carbamazepine) — dizziness, nausea, drowsiness, blurred or double vision, skin rashes, abnormal blood counts (rare).

Depakote (depakene, valproate, valproic acid) — dizziness, nausea, vomiting, tremor, hair loss, weight gain, depression in adults, irritability in children, reduced attention, and a decrease in thinking speed. Over the long term, the drug can cause bone thinning, swelling of the ankles, irregular menstrual periods. More rare and dangerous effects include hearing loss, liver damage, decreased platelets (clotting cells), and pancreas problems.

Diamox (acetazolamide) — appetite loss, frequent urination, drowsiness, confusion, extremity numbness, kidney stones.

Diastat acudial (diazepam rectal gel) — drowsiness, sleepiness, fatigue, dizziness, headache, pain, diarrhea, rash, nervousness, slowed speech, poor coordination, unsteadiness, behavior changes.

Felbatol (felbamate) — anorexia, vomiting, insomnia, nausea, headache, dizziness, vision problems, poor coordination, tremor, mood changes, anxiety, depression, liver and blood toxicity. (If you are taking it, have blood cell counts and liver tests regularly.

Frisium (clobazam) – weakness, drowsiness, dizziness, poor coordination, drooling, restlessness, aggressiveness, anxiety, increased heart rate, tremor, addictive. (Not sold in the United States.)

Gabitril (tiagabine) – nausea, dizziness, vomiting, diarrhea, tremor, nervousness, difficulty concentrating, irritability, anxiety, and confusion.

Hp Acthar Gel (acth [adrenocorticotropic hormone]) — insomnia, increased appetite, weight

gain, irritability, fluid retention. Sleepiness, fatigue, poor coordination, loss of strength, dizziness.

Klonopin (clonazepam), Valium (Diazepam), Xanax (alprazolam) — drowsiness, loss of appetite, poor coordination, unsteadiness, mood and behavior changes, addiction.

Lamictal (lamotrigine) — dizziness, nausea, fatigue, headache, blurred vision, clumsiness. Also, in rare cases, Lamictal can cause Stevens-Johnson Syndrome which poses a dangerous risk if not treated immediately.

Lyrica (pregabalin) — weight gain, swelling of hands and feet, nausea, sleepiness, blurred or double vision, dry mouth, difficulty concentrating, confusion, dizziness, weakness, tremor.

Mysoline (primidone) — clumsiness, unsteadiness, vertigo, dizziness, appetite loss, nausea, vomiting, fatigue, irregular eye movements, blurred or double vision, hyperirritability, insomnia, depression, hyperactivity (children).

Neurontin (gabapentin) — weight gain, ankle swelling, fatigue, dizziness, clumsiness, twitching.

Phenobarbital (luminal) — drowsiness, dizziness, upset stomach, anemia, rash, fever, vitamin folic acid deficiency, low calcium levels, bone loss, irritability, depression, hyperactivity (children), difficulty concentrating, memory problems, slurred speech, decreased sexual interest, mildly addictive.

Phenytek (extended phenytoin sodium) — constipation, dizziness, headache, nausea, trouble sleeping, vomiting, high blood sugar, clumsiness, confusion, jerking movements of the eyes, decreased coordination, shaking hands, slowed thinking, movement, memory problems, slurred speech, poor concentration, new or worsening mental or mood changes, seizures.

Rufinamide (inovelon) — headache, dizziness, fatigue, nausea, sleepiness, double vision, balance problems. Newly approved by the FDA.

Sabril (vigabatrin) — headache dizziness, tremor, blurry vision, vision loss, abnormal MRIs, anemia, sleepiness, numbness of extremities, weight gain, swelling, fluid retention, hyperactivity, memory impairment, constipation, diarrhea, urinary tract infection, upper respiratory tract infection,poor coordination, joint pain. Newly approved by the FDA.

Tegretol (carbamazepine, carbatrol) Tegretol XR (extended release carbamazepine) — dizziness, sleepiness, unsteadiness, drowsiness, blurred or double vision, headache, nausea, skin rashes, abnormal blood counts, bone and liver problems. (You must be tested for toxicity regularly.)

Topamax (topiramate) — weight loss, nausea, sleepiness, dizziness, tingling skin, clumsiness, unsteadiness, confusion, nervousness, difficulty thinking or talking, speech, memory and vision problems,feeling of pins and needles in fingertips and toes, depression, memory difficulty,  psychiatric disorders.

Tranxene (clorazepate) — drowsiness, sleepiness, fatigue, poor coordination, unsteadiness, behavior change.

Trileptal (oxcarbazepine) — difficulty concentrating, sleepiness, fatigue, dizziness, double vision, nausea, headache, unsteadiness, loss of coordination, rash, low blood sodium.

Vimpat (lacosamide) – dizziness, unsteadiness, shakiness, headache, nausea, vomiting, double vision, blurred vision, drowsiness, diarrhea, falling, unintentional rapid eye movement, tremor, memory mood problems.  (In rare cases, Vimpat may affect internal organs, blood counts or heart rhythm.)

Zarontin (ethosuximide) — appetite loss, nausea, vomiting, diarrhea, weight loss, drowsiness, headache, dizziness, fatigue, double vision, memory, mood problems.

Zonegran (zonisamide) — sleepiness, dizziness, loss of appetite, headache, nausea, irritability, difficulty concentrating, poor coordination, tremor, speech problems, unsteadiness, fever, itching, vision problems, kidney stones, abdominal discomfort. (Should not be used in individuals allergic to sulfa drugs).