Gabapentin Carbamazepine

Vigabatrin (not marketed in United States), tiagabine, topiramate, gabapentin, carbamazepine, lamotrigine... 

Anticonvulsants Carbamazepine, valproic acid, gabapentin, topiramate... 

Outside of the evidence-based guidelines, other pharmacologic treatments are commonly used or avoided. For initial treatment of absence seizures, ethosuximide and valproate are commonly used, not only in the United Kingdom, but also in the United States. Zonisamide may be also used for initial treatment of absence and myoclonic seizures. In absence and myoclonic seizures, carbamazepine, oxcarbazepine, gabapentin, tiagabine, and pregabalin should be avoided, as they have been associated with an exacerbation of these types of seizures. 

Antiepileptics Phenytoin Carbamazepine Valproic acid Gabapentin Vigabatrin Ethosuximide Benzodiazepines... 

Carbamazepine, phenytoin, valproate, gabapentin, lamotrigine, levetiracetam, tiagabine, topiramate, zonisamide... 

Valproic acid may cause less cognitive impairment than phenytoin and phenobarbital. Some of the newer agents (e.g., gabapentin and lamotri-gine) have been shown to cause fewer cognitive impairments than the older agents (e.g., carbamazepine). Topiramate may cause substantial cognitive impairment. 

Anticonvulsants. Finally, several antiseizure medications have been tried. These include valproic acid (Depakote, Depakene), carbamazepine (Tegretol), Lamotrig-ine (Lamictal), and gabapentin (Neurontin). The anticonvulsants are effective treatments for bipolar disorder. Their use for major depression needs to be studied further. Please refer to Section 3.4 Bipolar Disorders. 

Anticonvulsants. Several antiseizure medicines have been studied in the treatment of PTSD, and some results have been encouraging. Open label studies, first with carbamazepine (800-1200 mg/day) and later with valproate (500-2000 mg/ day), demonstrated overall improvement in PTSD patients, though not for intrusive recollections per se. Recent open label studies of gabapentin, lamotrigine, tiagabine, and topiramate have suggested these anticonvulsants might also be helpful for some PTSD symptoms. 

Mood Stabiiizers. First lithium and more recently valproic acid (Depakote, Depakene), carbamazepine (Tegretol), and gabapentin (Neurontin) have been used to treat agitated dementia patients. 

Carbamazepine, phenytoin, pheno-barbital, and other anticonvulsants (except for gabapentin) induce hepatic enzymes responsible for drug biotransformation. Combinations between anticonvulsants or with other drugs may result in clinically important interactions (plasma level monitoring ). 

Rowan AJ, Ramsay RE, Collins JF, et. al. New onset geriatric epilepsy a randomized study of gabapentin, lamotrigine, and carbamazepine. Neurology 2005 64 1868-1873. 

In the Expert Consensus survey (Rush and Frances, 2000), the respondents endorsed divalproex/valproic acid and carbamazepine as first-line medicines, followed by lithium and gabapentin (second-line interventions). Unfortunately, there are insufficient data on use of any of these—except, perhaps, on lithium—to draw any conclusions at this time. 

More recently, gabapentin has been added to the arsenal of medications used for the treatment of chronic pain, along with other anticonvulsant drugs, such as carbamazepine and clonazepam, as used in the treatment of neuropathies in children (Berde et ah, 1993 Green and Kowalik 1994). 

Other agents with anticonvulsant properties that may be of use m the treatment of bipolar disorder include topiramate, gabapentin, tiagabine and carbamazepine (Janicak et al., 2001). 

Another group of mood-stabilizing drugs that are also anticonvulsant agents have become more widely used than lithium. These include carbamazepine and valproic acid for the treatment of acute mania and for prevention of its recurrence. Lamotrigine is approved for prevention of recurrence. Gabapentin, oxcarbazepine, and topiramate are sometimes used to treat bipolar disorder but are not approved by FDA for this indication. Aripiprazole, chlorpromazine, olanzapine, quetiapine, risperidone, and ziprasidone are approved by FDA for the treatment of manic phase of bipolar disorder. Olanzapine plus fluoxetine in combination and quetiapine are approved for the treatment of bipolar depression. 

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