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Summary of Adverse Effects

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Carbamazepine: nausea/vomiting; diarrhoea; rash, pruritus (itching); fluid retention (low sodium); drowsiness, dizziness, blurred vision, lethargy, headache, tinnitus, paraesthesia (tingling), abnormal involuntary movements, leg cramps. Urinary frequency or occasionally acute urinary retention may occur.

Valproate: weight gain, nausea, vomiting, hair loss, bruising, tremor.

Gabapentin: indigestion, loss of appetite, constipation, dry mouth, sore gums, itching, fatigue, impotence, fluid retention and weight gain; pain/ burning/ tingling in hands and feet; sedation (or restlessness), ataxia (staggering, drunken gait) dizziness.

Lamotrigine: severe rash (see above) gastrointestinal upset; dizziness, tremor, ataxia, diplopia (double vision), headache.

Topiramate: fatigue, renal calculi (kidney stones); tremor, headache, epistaxis (nosebleeds); swelling of face/lips or tongue; rash/itching; tingling/pain/numbness in hands or feet; hearing impairment; ataxia, dizziness, cognitive (thinking) difficulties; agitation/irritability; mood changes, including depression.

Carbamazepine, valproate and lamotrigine can cause rare idiosyncratic reactions such as Stevens-Johnson syndrome (all 3 can cause this), and carbamazepine and valporate can also cause (rarely) aplastic anaemia, agranulocytosis, serum sickness (all are blood disorders) pancreatitis, hepatic (liver) failure.