Table 1

 Commonly used first line antiepileptic drugs in older people

DrugRecommended seizure typePharmacokineticsCommon side effectsPlasma therapeutic ranges
CarbamazepineFocal/generalised (1° or 2°)Enzyme inducerrash, diplopia, headache dizziness, conduction block20–50 μmol/l (optimal)
Sodium valproateAnyNo enzyme inductionTremor, weight gain
LamotrigeneExcept myoclonicNo enzyme inductionRash
PhenytoinGeneralised tonic-clonic and tonicEnzyme inducerGum hypertrophy40–80 μmol/l (trough)
Megaloblastic anaemia
Toxic symptoms and signs— ataxia, nystagmus, sedation dysarthria, diplopia