Recommended Anti-Epileptic Medications for Different Seizure Types

Page by: E.J. Mayeaux, Jr., M.D.
Louisiana State University Medical Center Shreveport, Louisiana

Seizure type

• First-line drugs
  • Notes

Absence seizures

• Ethosuximide (Zarontin)
• Valproic acid (Depakote)
  • Phenytoin is not effective for treating absence seizures, and phenobarbital and carbamazopine may worsen these seizures.
  • In patients with both absence and generalized tonic­clonic seizures, Valproic acid is preferable to ethosuximide, which is not effective against generalized tonic­clonic seizures.
  • The combination of ethosuximide and phenytoin is used for patients with absence seizures and generalized tonic­clonic seizures who cannot take Valproic acid.
  • Lamotrigine (Lamictal) appears effective against absence seizures and primary generalized tonic­clonic seizures.

Partial seizures with or without secondary generalization

• Carbamazepine (Tegretol)
• Phenytoin (Dilantin)
• Gabapentin (Neurontin
• Lamotrigine (Lamictal)
• Valproic acid
• Phenobarbital (Luminal)
• Primidone (Mysoline)
• Topiramate (Topamax)
  • Gabapentin (Neurontin), lamotrigine and topiramate are also effective.

Primary generalized tonic­clonic seizures

• Phenytoin
• Valproic acid
• Carbamazepine (Tegretol)
• phenobarbital

Myoclonic seizures

• Valproic acids
• Clonazepam (Klonopin)

Mixed seizures (myoclonic and tonic­clonic; juvenile myoclonic and absence seizures)

• Valproic acid

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