Anticonvulsant Drugs Health Article

Special conditions

People with certain medical conditions or who are taking certain other medicines can have problems if they take anticonvulsant drugs. Before taking these drugs, be sure to let the physician know about any of these conditions:

ALLERGIES. Anyone who has had unusual reactions to anticonvulsant drugs or to tricyclic antidepressants such as imipramine (Tofranil) or desipramine (Norpramin) in the past should let his or her physician know before taking the drugs again. The physician should also be told about any allergies to foods, dyes, preservatives, or other substances.

PREGNANCY. Birth defects have been reported in babies born to mothers who took anticonvulsant drugs during pregnancy. Women who are pregnant or who may become pregnant should check with their physicians about the safety of using anticonvulsant drugs during pregnancy.

Some anticonvulsant drugs taken during pregnancy may cause bleeding problems in the mother during delivery and in the baby after delivery. This problem can be avoided by giving vitamin K to the mother during delivery and to the baby after birth.

Pregnancy may affect the way the body absorbs anti-convulsant drugs. Women who are prone to seizures may have more seizures during pregnancy, even though they are taking their medicine regularly. If this happens, they should check with their physicians about whether the dose needs to be increased.

BREASTFEEDING. Some anticonvulsant drugs pass into breast milk and may cause unwanted effects in babies whose mothers take the medicine. Women who are breastfeeding should check with their physicians about the benefits and risks of using anticonvulsant drugs.

DIABETES. Anticonvulsant drugs may affect blood sugar levels. Patients with diabetes who notice changes in the results of their urine or blood tests should check with their physicians.

OTHER MEDICAL CONDITIONS. Before using anti-convulsant drugs, people with any of these medical problems should make sure their physicians are aware of their conditions:

• liver disease
• kidney disease
• thyroid disease
• heart or blood vessel disease
• blood disease
• brain disease
• problems with urination
• current or past alcohol abuse
• behavior problems
• diabetes mellitus
• glaucoma
• porphyria
• systemic lupus erythematosus
• fever higher than 101°F (38.3°C) for more than 24 hours

USE OF CERTAIN MEDICINES. Taking anticonvulsant drugs with certain other drugs may affect the way the drugs work or may increase the chance of side effects.

Side effects

The most common side effects are constipation, mild nausea or vomiting, and mild dizziness, drowsiness, or lightheadedness. These problems usually go away as the body adjusts to the drug and do not require medical treatment. Less common side effects, such as diarrhea, sleep problems, aching joints or muscles, increased sensitivity to sunlight, increased sweating, hair loss, enlargement of facial features, excessive hair growth, muscle twitching, and breast enlargement in males also may occur and do not need medical attention unless they persist or are troublesome.

Other side effects may need medical attention. If any of these side effects occur, check with a physician as soon as possible:

• clumsiness or unsteadiness
• slurred speech or stuttering
• trembling
• unusual excitement, irritability, or nervousness
• uncontrolled eye movements
• blurred or double vision
• mood or mental changes
• confusion
• increase in seizures
• bleeding, tender, or swollen gums
• skin rash or itching
• enlarged glands in neck or armpits
• muscle weakness or pain
• ever

Other side effects are possible. Anyone who has unusual symptoms after taking anticonvulsant drugs should get in touch with his or her physician.

Interactions

Some anticonvulsant drugs should not be taken within two to three hours of taking antacids or medicine for diarrhea. These medicines may make the anticonvulsant drugs less effective. Ask the pharmacist or physician for more information.

Birth control pills may not work properly when anti-convulsant drugs are being taken. To prevent pregnancy, ask the physician or pharmacist if additional methods of birth control should be used while taking anticonvulsant drugs.

Anticonvulsant drugs may interact with many other medicines. When this happens, the effects of one or both of the drugs may change or the risk of side effects may be greater. Anyone who takes anticonvulsant drugs should let the physician know all other medicines he or she is taking. Among the drugs that may interact with certain anticonvulsant drugs are:

• airway opening drugs (bronchodilators) such as aminophylline, theophylline (Theo-Dur and other brands), and oxtriphylline (Choledyl and other brands)
• medicines that contain calcium, such as antacids and calcium supplements
• blood thinning drugs
• caffeine
• antibiotics such as clarithromycin (Biaxin), erythromycins, and sulfonamides (sulfa drugs)
• disulfiram (Antabuse), used to treat alcohol abuse
• fluoxetine (Prozac)
• monoamine oxidase inhibitors (MAO inhibitors) such as phenelzine (Nardil) or tranylcypromine (Parnate), used to treat conditions including depression and Parkinson's disease
• tricyclic antidepressants such as imipramine (Tofranil) or desipramine (Norpramin)
• corticosteroids
• acetaminophen (Tylenol)
• aspirin
• female hormones (estrogens)
• male hormones (androgens)
• cimetidine (Tagamet)
• central nervous system (CNS) depressants such as medicine for allergies, colds, hay fever, and asthma; sedatives; tranquilizers; prescription pain medicine; muscle relaxants; medicine for seizures; sleep aids; barbiturates; and anesthetics
• alcohol
• other anticonvulsant drugs

The list above does not include every drug that may interact with anticonvulsant drugs. Be sure to check with a physician or pharmacist before combining anticonvulsant drugs with any other prescription or nonprescription (over-the-counter) medicine.