Epilepsy - Medications

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This drug is not useful for the following seizures:

• Petit mal seizures
• Myoclonic seizures
• Atonic seizures

Side Effects. Different side effects may develop or resolve at different points in the treatment duration. Initial side effects may include:

• Double vision, headache, sleepiness, dizziness, and stomach upset. These usually subside after a week and can be greatly reduced by starting with a small dose and building up gradually.
• Some people experience visual disturbances, ringing in the ears, agitation, or odd movements when drug levels are at their peak. The extended-release form of carbamazepine (Carbatrol) may help reduce these symptoms.

Serious side effects are less common but can include:

• Carbamazepine may increase the risk for birth defects, especially if it is taken during the first trimester of pregnancy.
• Skin reactions that are so severe that the drug has to be discontinued develop in about 6% of patients.
• Water retention can be a problem in older people.
• Hormonal changes, particularly higher levels of male hormones in both men and women, pose some risk for sexual dysfunction over time.
• A decrease in white blood cells occurs in about 10% of those taking the drug. This is generally not serious unless infection accompanies it.
• Other blood conditions can arise that are also potentially serious. Patients should be sure to inform the doctor if they have any sign of irregular heartbeats, sore throat, fever, easy bruising, or unusual bleeding.
• Long-term therapy can cause bone loss (osteoporosis) in women, who should take preventive calcium and vitamin D supplements.
• Children are at higher risk for behavioral problems.

Note: Citrus fruit, especially grapefruit, can increase carbamazepine's adverse effects and should be avoided by those taking this drug.

Phenytoin

Phenytoin (Dilantin) is effective for adults who have the following seizures or conditions:

• Grand mal seizures
• Partial seizures
• Status epilepticus
• Can be effective for people with head injuries who are at high risk for seizures