Epilepsy and the gut: Perpetrator or victim?

Table 2 Common gastrointestinal side effects of antiseizure medications[122-129]

Antiseizure medications	Common gastrointestinal side effects
Carbamazepine	Dry mouth, mouth sores, glossitis, loss of appetite, dysphagia, nausea, vomiting, hurt burn, gastritis, stomach/abdominal pain, constipation, diarrhea, abnormal liver functions, cholestatic and/or hepatocellular jaundice, hepatitis; hepatic failure (very rare), and pancreatitis (rare), eosinophilic colitis
Ethosuximide	Anorexia, nausea, vomiting, gastric pain, diarrhea, gastric and intestinal atony with decreased peristaltic activity
Phenobarbital	Diarrhea, sore throat, swelling of the tongue/throat, nausea, vomiting, constipation, dysphagia, and heartburn. As it is a cytochrome P450 hepatic enzyme inducer, it can cause abnormal hepatic function, hepatitis, liver damage, cholestasis, toxic hepatitis, and jaundice
Phenytoin	Changes in taste sensation, gingival overgrowth, sore throat, mouth ulcers, diarrhea, nausea, vomiting, constipation, dysphagia, heartburn, idiosyncratic hepatotoxicity (< 1% of the patients), reduced gastrointestinal absorption of calcium, reduced hepatic synthesis of 25-hydroxycholecalciferol, cause a relative vitamin K deficiency
Valproate	Diarrhea, nausea, vomiting, constipation, dysphagia, gastritis with heartburn, several distinctive forms of acute and chronic liver injury, and vitamin D deficiency
Gabapentin	Vomiting, constipation, gastritis, pancreatitis
Topiramate	Taste perversion, anorexia, nausea, abdominal pain, indigestion, diarrhea, constipation
Lamotrigine	Dry mouth, nausea, vomiting, gastritis, diarrhea, or constipation