Antiepileptic Drugs

  • H. J. Zimmerman
  • K. G. Ishak
Part of the Handbook of Experimental Pharmacology book series (HEP, volume 121)


The frequent, concurrent use of several drugs has hampered the evaluation of the hepatotoxic potential of individual anticonvulsants. Nevertheless, it has been possible to characterize the hepatic injury associated with the commonly used anticonvulsive agents. Although at least 30 drugs have seen use as anticonvulsants, only 3 have drawn attention as important causes of hepatic injury (ZIMMERMAN and MADDREY 1993). These include phenytoin, carbamazepine, and valproic acid. While this chapter will focus on these three agents, reference will be made to other anticonvulsants that have been implicated in hepatic injury (Table 1). The hepatic injury produced by anticonvulsants is quite uniform. That associated with phenytoin and valproic acid is predominately hepatocellular. Rare instances of phenytoin-induced injury have been cholestatic, and carbamazepine jaundice may be either hepatocellular or cholestatic.


Valproic Acid Antiepileptic Drug Hepatic Injury Sodium Valproate Carnitine Deficiency 
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  • H. J. Zimmerman
  • K. G. Ishak

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