ANTICONVULSANT DRUG CLASSIFICATION
BARBITURATES
Phenobarbitol
Primidone
Mephobarbitol
HYDANTOIN
Phenytoin
Mephenytoin
Ethotoin
Fosphenytoin
SUCCINIMIDES
Ethosuximide
Methsuximide
Phensuximide
SULFONAMIDES
Zonisamide
Trimethadione
OXAZOLIDINEDIONES
Paramethadione
Diazepam
Lorazepam
BENZODIAZEPINES
Clonazepam
Flebamate
Clorazepate
dipotassium
Carbamazepine
Valproic acid
Topiramate
Tiagabine
Levetiracetam
Drug
Carbamazepine
Mechanism
Act by reducing polysynaptic response and
blocking post synaptic potentiation.
Dose
Initial oral dose of 200 mg twice
daily. Gradually inc to 800-2000
mg daily in divided doses
Children <12 yrs: 10-20 mg/kg
daily
Phenytoin
Inhibits spread of seizures at motor cortex and
blocks posttetanic potentiation by influencing
synaptic transmission. There is an alteration of
ion fluxes in depolarization, repolarization, and
membrane stability phase and altering calcium
uptake in presynaptic terminals
LD: 900 mg – 1.5 mg iv
300-700 mg daily
Children: 4-7 mg/kg divided
every 12 hours. IV dose of 15
mg/kg may be given.
MISC
Lamotrigine
Gabapentin
Pregabalin
Oxcarbazeping
ADRS & SES
Jaundice, abd pain, pale stool,
darkened urine, unusual bruises
and bleeding, fever, sore throat,
mouth ulcer.
Dizziness, drowsiness,
unsteadiness, ataxia, diplopia,
nausea, vomiting, anorexia,
hyponatremia, aplastic anemia
(rare), thrombocytopenia, ameia,
pruritic and erythematous rashes,
steven-johnsons syndrome, and
lupus erythematosus
Swollen or tender gums, skin rash,
nausea, vomiting, slowwn glands,
bleeding, jaundice, fever, sore
throat, infection, ataxia,
dysarthria, insomnia,
maculopapular rashes, lupus
erythematosus, gingival
Valproic Acid
Increases levels of GABA; potentiates a
postsynaptic GABA response by inhibiting the
enzymatic response ofr the catabolism of GABA;
affects the potassium channel, creating a direct
membrane-stabilizing effect
Orally 1000-3000 mg daily in
divided doses
Children: 15-60 mg/kg daily in 23 divided doses
Should be taken with food
Phenobarbital
Increases the seizure threshold by decreasing
postsynaptic excitation by stimulating
postysynatic GABA-A receptor inhibitor
responses as a CNS depressant
90-300 mg daily in 3 divided
doses or single dose at bedtime
Children: 3-6 mg/kg in 2 dicided
doses
Lamotrigine
Similar to phenytoin. Inhibition of voltagedependent sodium currents and reduction of
sustained repetitive neuronal activity.
50 mg/day in 2 divided doses
(Patients taking valproic acid
must be given 25 mg every other
day) upto 100 mg/day in (25 mg
valproic acid daily)
Children: 0.6 mg/kg/day in two
divided doses (0.15 mg/kg/day if
on valproic acid) upto 1.2
mg/kg/day (0.3 mg/kg/day of
valproic acid)
hyperplasia, coarsening of facial
features, thrombocytopenia,
leukopenia, granulocytopenia
Abd pain, nausea, vomiting,
anorexia (signs of pancreatitis),
tremor, ataxia, diplopia, lethargy,
drowsiness, behavioral changes,
dipression, inc appetite, alopecia,
petechiae, thrombocytopenia,
bruising, hematoma, and beeding,
inc AST, ALT, LDH. Dec levels of
prolactin  irregular menses and
secondary amenorrhea
Sore throat, mouth sores, easy
bruising or bleeding, signs of
infection, agitation, confusion,
lethargy, drowsiness,
hypoventilation, apnea,
hypotension, bradycardia, nausea,
diarrhea, consiptaiton,
megaloblastic anemia,
osteomalacia, Steven-Johnson
syndrome
Dizziness, diplopia, ataxia, blurred
vision, nausea, dose-reated rash,
and vomiting, headache,
dyspepsia, diarrhea