Antiepileptics

The Side Effects of Drugs Annuals is a series of volumes in which the adverse effects of drugs and adverse reactions to them are surveyed. The series supplements the contents of Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions. This review of the 2015–2016 publications on antiepileptic drugs covers brivaracetam, carbamazepine, eslicarbazepine, ethosuximide, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, perampanel, phenobarbital and primidone, phenytoin and fosphenytoin, pregabalin, retigabine (ezogabine), rufinamide, topiramate, valproate sodium and semisodium (divalproex), vigabatrin, and zonisamide. Antiepileptic drugs often interact with other medications through multiple mechanisms including CYP P450 induction and inhibition. There is a focus on pharmacogenomics and the link between certain genetic aberrations and the propensity to develop adverse effects to antiepileptic medications, including CYP P450 metabolism. Specific genetic polymorphisms have been associated with psychiatric symptoms in patients taking levetiracetam, liver failure in patients taking valproic acid, neurologic side effects in patients taking carbamazepine, and an increased risk of severe cutaneous reactions in patients taking carbamazepine, lamotrigine, phenytoin, and phenobarbital.