Epilepsy - Surgery

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Carbamazepine

Carbamazepine (Tegretol, Equetro, Carbatrol, generic) is used for many types of epilepsy. It is taken alone or in combination with other drugs. In addition to controlling seizures, it may help relieve depression and improve alertness. A chewable form is available for children.

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.

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Serious side effects are less common but can include:

• Skin reactions, including toxic epidermal necrolysis and Stevens-Johnson syndrome, so severe the drug has to be discontinued develop in about 6% of patients. These skin reactions cause skin lesions, blisters, fever, itching, and other symptoms. People of Asian ancestry have a 10 times greater risk for skin reactions than other ethnicities.
• 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 their doctors if they have any sign of irregular heartbeats, sore throat, fever, easy bruising, or unusual bleeding.
• Long-term therapy can cause bone density loss (osteoporosis) in women, who should take preventive calcium and vitamin D supplements to improve bone mass.
• Children are at higher risk for behavioral problems.

Note: Citrus fruit, especially grapefruit, can increase carbamazepine's adverse effects.

Phenytoin

Phenytoin (Dilantin, generic) 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