Antiepileptic drugs used in adults

First line drugs
(generic name)

Available as
(brand name)

Average total dose in a day for adults

Treatment

Most common possible side effects include the following (report severe reactions, such as a skin rash, to your doctor).

Carbamazepine:
Tablets 100mg, 200mg, 400mg.

Tegretol:
Tablets 100mg, 200mg, 400mg.
Chewtabs 100mg, 200mg.
Liquid (sugar free) 100mg/5mL.
Suppositories 125mg, 250mg.

Tegretol Prolonged Release:
Tablets 200mg, 400mg.

Effective for tonic clonic seizures, and focal seizures.

Ineffective against absences.

May worsen myoclonic seizures.  

Skin rash.

Dry mouth, nausea, vomiting, fluid retention, unsteadiness, dizziness, drowsiness, fatigue, headache, low sodium in the blood, blood disorders, dermatitis, and hives.

Ethosuximide:
Capsules 250mg.

Emeside:
Syrup 250mg/5mL.

Zarontin:
Syrup 250mg/5mL.

Lamotrigine:
Tablets 25mg, 50mg 100mg, 200mg.
Dispersible tablets 5mg, 25mg, 100mg.

Lamictal:
Tablets 25mg, 50mg, 100mg, 200mg.
Dispersible tablets 2mg, 5mg, 25mg, 100mg.

100mg - 200mg if taken alone or with sodium valproate.

200mg - 400mg if taken with phenytoin, phenobarbitone, or carbamazepine.

Taken in 1 or 2 doses a day.

Serious skin rash and hypersensitivity. Risk minimised with slow introduction.

Nausea, vomiting, diarrhoea, dry mouth, aggression, agitation, headache, drowsiness, dizziness, tremor, difficulty sleeping, unsteadiness, back pain, joint pain, eye movements, double vision, and blurred vision.

Levetiracetam:
Tablets 250mg, 500mg, 750mg, 1000mg.
Oral solution 100mg/ml.

Keppra:
Tablets 250mg, 500mg, 750mg, 1000mg.
Oral solution 100mg/1mL.  

Effective for focal seizures with or without secondary generalisation.

Add-on therapy for myoclonic seizures and Juvenile Myoclonic Epilepsy.  

Oxcarbazepine: Tablets 150mg, 300mg, 600mg.

Trileptal:
Tablets 150mg, 300mg, 600mg.
Oral suspension 60mg/mL. 

Skin rash.

Nausea, vomiting, constipation, diarrhoea, abdominal pain, dizziness, headache, drowsiness, agitation, amnesia, hair loss, weakness, unsteadiness, confusion, depression, and tremor.

Sodium Valproate: Tablets 200mg, 500mg.
Liquid 200mg/5mL.

Epilim:
Tablets 200mg, 500mg.
Crushable tablets 100mg.
Liquid (sugar free): 200mg/5mL.
Syrup 200mg/5mL.

Epilim Chrono (controlled release): Tablets 200mg, 300mg, 500mg.

Epilim Chronosphere: Sachets 50mg, 100mg, 250mg, 500mg, 750mg, 1000mg.

Episenta (prolonged release): Capsules 150mg, 300mg. Granules 500mg, 1000mg.

Hair loss - not usually severe and is usually reversible if the dose is reduced.

Nausea, stomach upset, diarrhoea, and weight gain (due to increased appetite), increased levels of ammonia in the blood, and reduced platelets in the blood.

Has been associated with polycystic ovaries and menstrual problems.

Sodium valproate carries a higher risk than other AEDs of causing developmental problems in unborn babies if taken during pregnancy. Having preconceptual counselling is recommended.

Second line drugs (generic name)

Available as
(brand name)

Average total dose in a day for adults

Treatment

Most common possible side effects include the following (report severe reactions, such as a skin rash, to your doctor).

Clobazam:
Tablets 10mg.

Frisium:
Tablets 10mg.

Clonazepam: Tablets 0.5mg, 2mg.

Rivotril:
Tablets 0.5mg, 2mg.

Skin rash.

Nausea, vomiting, diarrhoea, dizziness, drowsiness, headache, impaired coordination, tremor, visual problems, and fatigue (tiredness).

Gabapentin:
Tablets 600mg, 800mg.
Capsules 100mg, 300mg, 400mg.

Neurontin:
Tablets 600mg, 800mg.
Capsules 100mg, 300mg, 400mg.

Used for focal seizures where other treatment has not worked.

May make myoclonic and absence seizures worse.

Rash.

Diarrhoea, nausea, vomiting, dry mouth, appetite changes, weight gain, high blood pressure, fluid retention, confusion, depression, sleep disturbance, headache, dizziness, anxiety, tremor, unsteadiness, flu-like symptoms, incontinence, impotence, and double vision.

Rash.

Hepatitis, low blood pressure, drowsiness, lethargy, depression, unsteadiness, and impaired memory or cognition.

Phenytoin:
Tablets 100mg.

Epanutin:
Chewable Infatabs 50mg.
Suspension 30mg/5mL.

Phenytoin Sodium Flynn:
Hard capsules 25mg, 50mg, 100mg, 300mg.

Effective for focal and tonic clonic seizures.

Ineffective against absences.

Blood testing is essential to guide the doses.

Skin rash.

Nausea, vomiting, constipation, drowsiness, insomnia, nervousness, tremor, pins and needles, dizziness, headache, anorexia, gum problems, acne, excess hair growth, and coarsening of facial features.

Rash.

Weight gain, nervousness, and overactive restlessness.

Lyrica:
Capsules 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, 225mg, 300mg.

Oral solution 20mg/ml. 

Effective for focal and tonic clonic seizures.

May be ineffective against absences.

Rash.

Hepatitis, low blood pressure, drowsiness, lethargy, depression, unsteadiness, impaired memory or cognition, and nausea.

900mg - 1200mg divided into 3 doses a day.

Add-on therapy for focal seizures.

Inovelon: Tablets 100mg, 200mg, 400mg.

Oral suspension 40mg/ml.

Hypersensitivity syndrome (possibly including rash and fever) – if
concerned seek immediate medical attention.

Nausea, vomiting, constipation, diarrhoea, indigestion, abdominal pain, weight loss, anorexia, runny
nose, nosebleeds, dizziness, headache, drowsiness, insomnia, anxiety, tiredness, flu-like symptoms, and blurred or double vision.

Diacomit Capsules 250mg, 500mg.

Powder sachets 250mg, 500mg.

Nausea, vomiting, aggression, anorexia, unsteadiness, drowsiness, muscle contractions, excitability, overactive restlessness, low muscle tone, irritability, sleep problems, weight loss, and reduced immunity.

Used for focal seizures where other treatment has not worked.

May make myoclonic seizures worse.

Up to 400mg a day if taken alone. 200mg - 400mg a day if taken with other AEDs.

Taken in 2 doses a day.

Used for focal seizures where other treatment has not worked.

Topiramate has a licence for monotherapy but is not widely used as a first-line drug.

Rash.

Nausea, diarrhoea, vomiting, constipation, indigestion, abdominal
pain, dry mouth, appetite changes, impaired attention, cognition and
coordination, movement problems, tremor, drowsiness, dizziness,
anxiety, confusion, mood changes, depression, irritability, and anaemia.

Effective for focal seizures and secondarily generalised seizures where other treatment has not worked.

Used for West syndrome with Tuberous Sclerosis.

May worsen absence and myoclonic seizures.

Nausea, abdominal pain, fluid retention, drowsiness, fatigue, agitation, dizziness, headache, nervousness, depression, aggression, impaired concentration or memory, tremor, and weight gain.

Visual field defects have been reported in some adults: visual fields should be checked every six months. Talk to your GP or neurologist if you are concerned about this.

Skin rash.

Nausea, diarrhoea, abdominal pain, constipation, indigestion, anorexia, weight loss, drowsiness, dizziness, confusion, agitation, irritability, depression, psychosis, and unsteadiness.