Therapeutic spectrum of antiseizure medications

Broad spectrum:

Drugs used to treat a broad range of seizure types (both focal and generalized onset)

Brivaracetam
Clobazam
Felbamate
Lamotrigine*
Levetiracetam
Perampanel
Rufinamide
Topiramate
Valproate
Zonisamide

Narrow spectrum (focal):

Drugs used primarily for focal-onset seizures (including focal evolving to bilateral convulsive seizures^¶)

Carbamazepine^Δ
Cenobamate
Eslicarbazepine^◊
Gabapentin^◊
Lacosamide
Oxcarbazepine^◊
Phenobarbital^Δ
Phenytoin^Δ
Pregabalin
Primidone^Δ
Stiripentol
Tiagabine^◊
Vigabatrin^◊

Narrow spectrum (absence):

Absence seizures only (a type of generalized seizure)

Ethosuximide

Note that although there is evidence to support the use of these medications for these seizure types, the medication may not be indicated for this use by the US Food and Drug Administration.

* May worsen or precipitate myoclonic seizures.
¶ Previously referred to as secondary generalized seizures.
Δ Some evidence of efficacy for generalized-onset tonic-clonic seizures, but may also worsen certain generalized seizure types.
◊ Potential to worsen certain generalized seizure types.

Graphic 78021 Version 17.0

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Therapeutic spectrum of antiseizure medications