Similar to carbamazepine; 100% bioavailability; 1-2 h t1/2 but active metabolites with t1/2 of 8-12 h; fewer interactions reported acetate: Similar to oxcarbazepine but shown to be effective when given once daily and may be more rapidly converted to the active metabolite • ValproateUnknown Nearly complete (>90%) absorption •peaklevelsformulationdependent•highly(90%)boundtoplasmaproteins•extensivelymetabolizedinliver•t1/2 5–16 h Generalized tonic-clonic seizures, partial seizures, absence seizures, myoclonic seizures, other generalized seizure; migraine prophylaxis Toxicity: Nausea, tremor, weight gain, hair loss,teratogenic,hepatotoxic•Interactions: Phenobarbital, phenytoin, carbamazepine, lamotrigine, felbamate, rifampin, ethosuximide, primidone • LevetiracetamSV2A ligand Nearly complete (~95%) absorption •peaklevelsin1–2h•notboundtoplasmaproteins•minimalmetabolismin blood to inactive metabolite; ~66% excreted unchanged in urine •t1/2 6–11 h Focal seizures, generalized tonic-clonic seizures, myoclonic seizures Toxicity: Nervousness, dizziness, depression, seizures•Interactions: Rare Brivaracetam: Similar to levetiracetam but interaction with carbamazepine • Lorazepam: Similar to diazepam absorption • peak concentrations in 1–1.5 h • IV for status epilepticus • highly (95–98%) bound to plasma proteins • extensively metabolized to several active metabolites • t1/2 of active metabolite N-desmethyldiazepam up to 100 h
Bioavailability >80% • peak concentrations in 1–4 h • highly (86%) bound to plasma proteins • extensively metabolized in liver; no active metabolites • t1/2 12–56 h Status epilepticus, seizure clusters; sedation, anxiety, muscle relaxation (muscle spasms, spasticity), acute alcohol withdrawal
Absence seizures, myoclonic seizures, infantile spasms
Toxicity: Sedation • Interactions: Additive with sedative-hypnotics
Toxicity: Similar to diazepam • Interactions:
Additive with sedative-hypnotics • Clobazam: Indications include absence seizures, myoclonic seizures, infantile spasms