Epilepsy in Pregnancy

Table 4. Drug Table Agent (Brand) Dose* carbamazepine (CBZ) Tegretol , Carbatrol , Equetro ethosuximide (ESM) Zarontin gabapentin (GBP) Neurontin lamotrigine (LTG) Lamictal Initial: 200 mg bid Maximum: 1200 mg/d Initial: 250 mg/d PO Maximum: 1500 mg/d PO Initial: 300 mg tid Maximum: 1800 mg/day Initial: 25 mg/d Maximum: 200 mg/d levetiracetam (LVT) Keppra oxcarbazepine (OXC) Trileptal phenobarbital (PB) generic, Solfoton phenytoin (PHT) Dilantin primidone (PRM) Mysoline topiramate (TPM) Topamax Initial: 1 gm/d Maximum: 3 gm/d Initial: 600 mg/d Maximum: 1200 mg/d 50-100 mg bid-tid Initial: 100 mg tid Maximum: 600 mg/d Initial: 100 to 125 mg at bedtime Maximum: 500 mg qid Initial: 25 mg bid Titrate up to maximum: 200 mg bid Indications* • partial seizures with complex symptomatology (psychomotor, temporal lobe) • generalized tonic-clonic seizures (grand mal) • mixed seizure patterns • trigeminal neuralgia • absence (petit mal) epilepsy • partial seizures • postherpetic neuralgia • partial seizures • primary generalized tonic-clonic seizures • blood dyscrasias • effects on liver and kidneys • systemic lupus erythematosus • suicidal behavior and ideation • suicidal behavior and ideation • withdrawal seizures • generalized seizures of Lennox-Gastaut syndrome • bipolar disorder • adjunctive Rx for partial onset, myoclonic and primary generalized tonic-clonic seizures • partial seizures • adjunctive Rx for epilepsy • generalized tonic-clonic and cortical local seizures • generalized tonic-clonic (grand mal) and complex partial (psychomotor, temporal lobe) seizures • grand mal, psychomotor, and focal epileptic seizures • partial onset or primary generalized tonic-clonic seizures • migraine • serious skin rashes • hypersensitivity reactions • acute multiorgan failure • blood dyscrasias • suicidal behavior and ideation • withdrawal seizures • status epilepticus • suicidal behavior and ideation • neuropsychiatric adverse events • withdrawal seizures • hyponatremia • anaphylactic reactions and angioedema • serious dermatological reactions • withdrawal seizures • habit forming • withdrawal seizures • withdrawal seizures • lymphadenopathy • status epilepticus • withdrawal seizures • suicidal behavior and ideation • status epilepticus • metabolic acidosis • acute myopia and secondary angle closure glaucoma • oligohidrosis and hyper thermia • psychiatric/behavioral problems • somnolence/fatigue valproate (VPA) Depakene, Depakote, Stavzor * See PI for details Initial: 5-15 mg/kg/day Maximum: 60 mg/kg/day • complex partial seizures • simple and complex absence seizures • bipolar disorder • migraine • hepatotoxicity • teratogenicity • pancreatitis • suicidal ideation • withdrawal seizures • cognitive neuropsychiatric disturbances Warnings* • serious dermatologic reactions • aplastic anemia and agranulocytosis

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