Abstract
Most patients with epilepsy will benefit from seizure control with one of an array
of chronic antiseizure medications. Knowledge of the potential long-term effects of
these medications is critical to prevent adverse consequences on overall health. Antiseizure
medications vary in their capacities to affect the brain and peripheral nerves, hormones,
bone mineralization, cardiovascular risk, renal health, hepatic, hematological, and
dermatological systems. Understanding of pathophysiology and population risk has evolved,
although most of the data available are still on older generation antiseizure medications
such as phenytoin, carbamazepine, and valproic acid. The enzyme-inducing properties
of some antiseizure medications make their effects on cardiovascular risk and bone
health detrimental. Few clear guidelines exist for monitoring long-term effects of
medication therapy for epilepsy. When selecting an antiseizure medication, consideration
should be given to the individual patient's risks of adverse consequences on other
organ systems. During monitoring of patients on chronic therapy, screening tools such
as metabolic panels and bone density measurements can help stratify risk and guide
management.
Keywords
antiseizure medication - epilepsy treatment - antiepileptic - anticonvulsant - seizure
treatment
