ANNOUNCER: Both the newer and older classes of medications seem to have similar efficacy, or ability to stop seizures. Their differences lay in their side effect profiles, with the newer medications tending to have milder side effects.
BLANCA VAZQUEZ, MD: The older antiepileptic drugs tend to have a heavier side effect profile, especially for cognition. The older drugs are associated with long-term use of and development of neuropathy, sedation, cognitive decline and mood changes. The newer antiepileptic drugs are also associated with some of those behavioral changes, but in a much milder level.
ANNOUNCER: And some side effects are related more closely to some drugs than others.
BLANCA VAZQUEZ, MD: The patients need to know what to look for or what side effects are not acceptable. For instance, the older antiepileptic drugs, like barbiturates, have a lot of sedation and mood changes. Dilantin is associated with major cognitive issues as well as bone loss and hormonal changes for female and male patients.
TRACY GLAUSER, MD: Medicines in general, such as Dilantin, can cause sedation, drowsiness, tiredness, wobbliness in walking and unsteadiness. A medicine like Dilantin can have the rare effect of causing a rash. In addition, chronic use of Dilantin can lead to changes in cosmetic features: coarsening of the facial bones, growing hair on the face, swelling of the gums. Tremor is more commonly seen in children taking valproic acid (also known as Depakote or Depakene).
