Keppra - (caused mood swings, at times very aggressive) Indications: Partial onset seizures (adjunct) Metabolism: 66% excreted unchanged by the kidneys; some metabolism by the liver Contraindicated: Hypersensitivity Use Cautiously in: OB: Lactaction. Geri: Renal elimination decreased; dose reduction may be necessary. Renal impairment (dose reduction recommended if CCr < 80 ml/minr.) Pedi: Children < 4 yr (safety not established). OB: Use only during pregnancy if potential benefits justifies potential risk to fetus. Adverse Reactions: CNS: dizziness, fatigue/somnolence,weakness,behavioral abnormalities. Neuro: coordination difficulties (adults only) Topamax - (increased Tonic Seizures, and some Status Epilepticus Seizures) Indications: Seizures including, partial-onset, primary generalized tonic-clonic, seizures due to Lennox-Gastaut syndrome. Prevention of migraine headace in adults. Metabolism: 70% excreted unchanged in urine Contraindicated: Hypersensitivity OB: Lactaction. Use Cautiously in: Renal impairment (dosage reduction recommended if CCr <70 ml/min/1.73m2 Hepatic impairment. Geri: Consider age-related decrease in renal/hepatic impairment, concurrent disease states and drug therapy. Pedi: Children are more prone to oligohydrosis and hyperthermia; safety in children <2 yr not established. Dehydration OB: Pregnancy (use only if maternal benefit outweighs fetal risk). Adverse Reactions: CNS: increased seizures dizziness, drowsiness,fatigue,impaired concentration/memory,nervousness,psychomotor slowing,speech problems,aggressive reaction,agitation,anxiety,cognitive disorders,confusion,depression,malaise,mood problems. EENT: abnomal vision,diplopia,nystagmus,acute myopia/secondary angle closure glaucoma. GI: nausea,abdominal pain,anorexia,constipation,dry mouth GU: kidney stones Derm: oligohydrosis (increased in children) F and E: hyperchloremic metabolic acidosis. Hemat: leukopenia Metab: weight loss, hyperthermia (increased in children) Neuro: ataxia, paresthesia, tremor Misc: suicide attempt, fever Depakote & Lamictal combination - (currently on. better days, but still some Tonic Seizures, not as often) Depakote: (currently on) Indications: Simple and complex absence seizures Partial seizures with complex symptomatology Metabolism: Mostly metabolized by the liver; minimal amounts excreted unchanged in urine Contraindicated: Hypersensitivity Hepatic impairment. Some products contain tartrazinel avoid in patients with known hypersensitivity. known/suspected urea cycle disorders (may result in fatal hyperammonemic encephalopathy) Use Cautiously in: Bleeding disorders History of liver disease Organic brain disease Bone marrow depression Renal impairment Pedi: Children, especially under 2yr, are at increased risk for potentially fatal hepatotoxicity. OB: Use during pregnancy is linked to developmental defects, low IQ, birth defects, congenital anomalies, and hepatic dysfunction in the neonate. Use with extreme caution. Lactation: Valproates pass into breast milk. Consider discontinuing nursing when valproates are administered to the nursing mother. Adverse Reactions: CNS: confusion,dizziness,headache,sedation EENT: visual disturbances GI: hepatotoxicity, indegestion, nausea, vomiting, anorexia, constipation, diarrhea, hypersalivation, increased appetite,Pancreatitis Derm: rashes Hemat: leukopenia,prolonged bleeding time,thrombocytopenia. Metab: hyperammonemia Neuro: ataxia, paresthesia Lamictal: (currently on) Indications: Adjunct treatment of partial seizures in adults with epilepsy. Lennox-Gastaut syndrome. Conversion to monotherapy in adults with partial seizures receiving a single enzyme-inducing antiepileptic drug. Maintenance treatment of bipolar disorder. Metabolism: Mostly metabolized by the liver to inactive metabolites; 10% excreted unchanged by the kidneys. Contraindicated: Hypersensitivity Lactation Use Cautiously in: Patients with reduced renal function (lower maintenance doses may be required). Patients with impaired cardiac function. Patients with impaired hepatic function (lower maintenance doses may be required) Pregnancy or children (safety not established as monotherapy). Prior history of rash to lamotrigine. Adverse Reactions: CNS: ataxia,dizziness,headache,behavior changes,depression,drowsiness,insomnia,tremor EENT: blurred vision,double vision,rhinitis GI: nausea,vomiting GU: vaginitis Derm: photosensitivity,rash (higher incidence in children, patients taking VPA, high initial doses, or rapid dosage increases). MS: arthralgia Misc: allergic reactions including Stevens-Johnson syndrome

Drugs Treating Seizure Disorders exercise

Drugs Used to Treat Seizures (....referenced, Merck)

Drug	Use	Possible Side Effects
Carbamazepine
	Partial and generalized seizures	Low white blood cell count (granulocytopenia), low red blood cell count (anemia), digestive upset, and visual disturbances
Clonazepam
	Absence, myoclonic, and atonic seizures and infantile spasms	Drowsiness, abnormal behavior, loss of muscle coordination, and tolerance of the drug after 1 to 6 months
Divalproex
	Absence and complex partial seizures and, when the drug is given by injection, status epilepticus	Nausea, vomiting, abdominal pain, diarrhea, weakness, drowsiness, dizziness, tremor, weight gain, and liver damage
Ethosuximide
	Absence seizures	Nausea, lethargy, dizziness, headache, low white blood cell count, and low red blood cell count
Felbamate
	Complex partial seizures in conjunction with other anticonvulsants when all other drugs are ineffective	Headache, fatigue, liver failure, and, rarely, aplastic anemia (a fatal disorder)
Fosphenytoin
	Status epilepticus	Loss of muscle coordination, drowsiness, dizziness, headache, rash, and tingling sensations
Gabapentin
	Complex partial seizures in conjunction with other anticonvulsants	Drowsiness, dizziness, weight gain, and headache
Lamotrigine
	Complex partial and generalized seizures in conjunction with other anticonvulsants	Rash, nausea, vomiting, indigestion, drowsiness, dizziness, runny nose, and abnormal menstrual periods in women
Levetiracetam
	Complex partial seizures in conjunction with other anticonvulsants	Drowsiness, dizziness, and fatigue
Lorazepam
	Status epilepticus	Drowsiness and slowing of heart and breathing rates
Midazolam
	Status epilepticus	Drowsiness and slowing of heart and breathing rates
Oxcarbazepine
	Complex partial seizures as the only anticonvulsant in adults or in conjunction with other anticonvulsants in children and adults	Headache, drowsiness, dizziness, fatigue, nausea, low sodium levels in the blood, and a low white blood cell count
Phenobarbital
	Partial and generalized seizures and status epilepticus	Drowsiness, paradoxical hyperactivity in children, rapid movement of the eyes in one direction followed by a slower drift back to the original position (nystagmus), confusion, and loss of muscle coordination
Phenytoin
	Partial and generalized seizures and, when the drug is given intravenously, status epilepticus	Swollen gums, low red blood cell count, loss of bone density, excessive hairiness (hirsutism), swollen glands, and, in children, impairment of cognitive development
Primidone
	Partial and generalized seizures	Drowsiness, paradoxical hyperactivity in children, nystagmus, and loss of muscle coordination
Tiagabine
	Complex partial seizures in conjunction with other anticonvulsants	Drowsiness, dizziness, confusion, weakness, nausea, abdominal pain, nervousness, muscle tremor, and knee buckling
Topiramate
	Complex partial seizures in conjunction with other anticonvulsants in adults	Confusion, word-finding difficulties, depression, loss of appetite, and kidney stones
Valproate
	Absence, myoclonic, generalized, and partial seizures and infantile spasms	Nausea, vomiting, weight gain, reversible hair loss, and temporary drowsiness
Vigabatrin
	Complex partial seizures in conjunction with other anticonvulsants	Drowsiness, dizziness, headache, and fatigue
Zonisamide
	Complex partial seizures in conjunction with other anticonvulsants	Drowsiness, loss of muscle coordination, kidney stones, loss of appetite, and nausea