long term effects
I did some more research. I didn't do all drugs. Just some. There are shockingly few studies and very little data about long term or permanent effects of our AEDs. Most of what was on the internet was the result of a doctor reporting a side effect to the FDA.
I included what info I could find with some quick searches. Most of the links have citations (links to studies). I
didn't comb the package inserts for short-term side effects that could be permanent, like liver failure.
I included the dates the drugs were approved by the FDA or introduced. Some of the drugs that were introduced recently, like in the last 20 years, probably have long-term effects that are presently unknown. Some have been out 40 or 50 years, which is probably enough time to know long-term effects.
Dilantin (Phenytoin)
Approved by the FDA in 1953.
http://en.wikipedia.org/wiki/Dilantin
Phenytoin may accumulate in the cerebral cortex over long periods of time, as well as causing atrophy of the cerebellum when administered at chronically high levels. Despite this, the drug has a long history of safe use, making it one of the more popular anti-convulsants prescribed by doctors, and a common "first line of defense" in seizure cases
...Phenytoin has been known to cause drug-induced lupus.
http://www.rxlist.com/dilantin-drug.htm
There have been a number of reports suggesting a relationship between phenytoin and the development of lymphadenopathy (local or generalized) including benign lymph node hyperplasia, pseudolymphoma, lymphoma, and Hodgkin's disease.
Dyskinesias, including chorea, dystonia, tremor, and asterixis, may be caused by phenytoin. Also, a small number of patients report sensory peripheral polyneuropathy.
http://www.epilepsy.com/EPILEPSY/SEIZURE_MEDICINES
Cerebellar atrophy may be another long-term effect of phenytoin, especially if high doses are used. Damage severe enough to produce significant problems is uncommon, however.
Depakote (Valproic Acid, sodium valproate):
Approved by the FDA in 1983
http://www.epilepsy.com/medications/b_depakote_side
Some people who have taken Depakote for many years have experienced bone loss and a few other disorders. Taking both calcium and vitamin D may help to prevent this kind of problem. Doctors sometimes recommend a bone density test to identify which people need treatment for bone loss.
http://en.wikipedia.org/wiki/Depakote
The above side effects suggest a possibility of liver damage.
(Note from endless: The bone loss is a side effect that's common for most of our meds, though. They suck the vitamin D right out of our bodies. Everybody in here should be taking D, as well as some other vitamins, and having their D and B tested at regular intervals.)
Tegretol (Carbamazepine):
Was introduced in the UK in 1965, in the U.S. in 1974
http://facial-neuralgia.org/treatments/drugs/carbamazepine.html
However, in the long term carbamazepine can have a variety of side effects. Various problems with vision may remain. A great many patients remain permanently exhausted and find their thought processes impaired. Memory loss is particularly common; since many patients are elderly, this is unfortunately often ignored as being due to dementia and aging. Nausea and dizziness is also possible...
[Tomson et al., 1988] note that carbamazepine may affect vision more heavily than older epileptic drugs (primarily phenytoin). Blurred vision is particularly common. The effect seem to be dose-dependent, but it is not clear whether stopping the drug will cause vision to recover fully.
http://en.wikipedia.org/wiki/Tegretol#Adverse_effects
Carbamazepine increases the risk of developing lupus by 1.88
Clonazepan
Approved by the FDA in 1975
http://en.wikipedia.org/wiki/Clonazepam#Long_term_effects
The long term effects of clonazepam can include; depression, disinhibition and sexual dysfunction.[51] Long-term use of benzodiazepines are also associated with cognitive impairments which persist for at least 6 months, but it is unclear whether these impairments may be permanent.
Gabapentin
Approved by the FDA in 1994
http://www.epilepsy.com/medications/b_gabapentin_side
The long-term side effects of gabapentin are not known.
http://en.wikipedia.org/wiki/Gabapentin#Adverse_effects
Gabapentin is also known to induce pancreatic acinar cell carcinomas in rats through an unknown mechanism, perhaps by stimulation of DNA synthesis; these tumors did not affect the lifespan of the rats and did not metastasize.
Keppra
Approved by the FDA in 2000.
Couldn't find any info on LT effects. The drug is too new.
Topamax (Topiramate)
Approved by the FDA in 1996
It is so recent that there is not much data on permanent side effects. There was some mention of hearing loss and glaucoma.
http://www.mayoclinic.com/health/drug-information/DR601527/DSECTION=side-effects
The mayo clinic article lists hearing loss, but does not say if it is permanent. (Hearing loss assumes nerve damage, so I'm guessing that it may be permanent)
http://en.wikipedia.org/wiki/Topamax#Side_effects
The Food and Drug Administration (FDA) has notified prescribers that topiramate can cause acute myopia and secondary angle closure glaucoma in a small subset of people who take topiramate regularly.[citation needed] The symptoms, which typically begin in the first month of use, include blurred vision and eye pain. Discontinuation of topiramate may halt the progression of the ocular damage, and may reverse the visual impairment.
Trileptal (Oxcarbazepine)
Introduced in 2000. Still too new to know it's LT affects. None known yet.
Vimpat (Lacosamide)
FDA approval in 2008, uk approval in 2008
Extremely new, so no data on LT effects. The clinical trials had a median length of only 12 weeks.
http://www.rxlist.com/vimpat-drug.htm
http://www.rxlist.com/vimpat-drug.htm
Ear and labyrinth disorders:
tinnitus
In clinical trials in patients with
diabetic neuropathy, asymptomatic first-degree AV block was observed as an adverse reaction in 0.5% (5/1023) of patients receiving VIMPAT and 0% (0/291) of patients receiving placebo. When VIMPAT is given with other drugs that prolong the PR interval, further PR prolongation is possible.
(Note from endless: Does not say if tinnitus is permanent, but usually tinnitus is caused by nerve damage in the ear. Did not say if AV block (heart problem) was permanent, either. The articles below may shed some light on that. I think the first article below says first-degree block is usually not serious, unless it progresses.)
More info on First-degree AV block:
http://www.patscotland.org.uk/medical_appendices/H/HEART BLOCK.pdf
http://www.wikidoc.org/index.php/First_Degree_AV_Block
Note from endless: The second article on AV Block, above, says digoxin results in reversible AV block. So maybe it's reversible when it's from Vimpat, too. (no data so who knows)
Another thought by me: most of this stuff has symptoms. If we stay in touch with our own bodies and go to the doctor right away when things aren't right, I bet our drug can be changed to another and we'd avoid most of the permanent side effects before they turn permanent. The only ones I'm really worried about are the ones that look temporary, but don't go away when we discontinue the drug. (like vision problems)
