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Review
. 2025 Jul 10:16:1584566.
doi: 10.3389/fphar.2025.1584566. eCollection 2025.

Adverse effects of antiseizure medications: a review of the impact of pharmacogenetics and drugs interactions in clinical practice

Michela De Bellis  1 , Giuseppe d'Orsi  2 , Egidio Maria Rubino  1 , Claudia Arigliano  1 , Massimo Carella  2 , Vittorio Sciruicchio  3 , Antonella Liantonio  1 , Annamaria De Luca  1 , Paola Imbrici  1
Affiliations
Review

Adverse effects of antiseizure medications: a review of the impact of pharmacogenetics and drugs interactions in clinical practice

Michela De Bellis et al. Front Pharmacol. .

Abstract

Epilepsy is a chronic and debilitating neurological disorder characterized by the occurrence of spontaneous and recurrent seizures. Despite the availability of several antiseizure medications (ASMs), people with epilepsy often experience drug resistance and adverse effects. This narrative review provides an overview of the main adverse drug reactions (ADR) caused by ASMs, including neurological, metabolic, skin reactions and drug failure, and of the underlying molecular mechanisms. Given the critical contribution of pharmacogenomics and drug-drug interactions to the occurrence of some ADRs, we provide examples of the role of major allelic variations identified in genes encoding for molecules involved in the pharmacokinetics, pharmacodynamics and immune system and emphasize the activity of ASMs as inhibitors or inducers of metabolic enzymes. Improved knowledge of the benefit-risk profile of drugs, also through enhanced pharmacovigilance activity and following guidelines recommendations, could implement patients care avoiding ADRs and favoring a beneficial personalized medicine particularly in vulnerable patients as children, elderly people and pregnant women.

Keywords: adverse drug reactions; antiseizure medications; drug interactions; epilepsy; pharmacogenetics.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

FIGURE 1
FIGURE 1
Antiseizure medications available for the treatment of epilepsy and year of market release.
FIGURE 2
FIGURE 2
Sources of variability in the response to ASMs.
FIGURE 3
FIGURE 3
Teratogenic risk profile of ASMs.
FIGURE 4
FIGURE 4
Some polymorphic genes proposed to be involved in drug-resistant epilepsy.
See this image and copyright information in PMC

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