What medications interact with anticonvulsants?

Donna Hill Howes, RN
Family Practitioner

If you are taking an anticholinergic drug, metformin, primidone, rufinamide, a selective serotonin reuptake inhibitor, or valproate, topiramate may not be a good option for you.

If you are using azelastine nasal spray, a carbonic anhydrase inhibitor, a central nervous system depressant, a hormonal contraceptive, orphenadrine, paraldehyde, thalidomide, or ulipristal, topiramate can lead to side effects and should be avoided.

If you are taking lamotrigine, valproic acid may not be a good option for you.

If you are taking a salicylate, valproic acid and topiramate may not be good options for you.

If you take topiramate, you should avoid kava kava. 

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Dr. John Preston, PsyD
Psychology Specialist

Anticonvulsants can interact adversely with the following medications. Interactions vary depending on the specific anticonvulsant.

  • birth control pills (especially with Tegretol; may occur with Topamax, a medication that does not treat bipolar symptoms but is commonly prescribed to bipolar patients to reduce weight gain)
  • anticoagulants
  • aspirin (moderate to high doses)
  • cimetidine (Tagamet)
  • antibiotics (especially with Tegretol)
  • calcium channel blockers
  • propoxyphene (Darvon; especially with Tegretol)
  • antidepressants (high doses)
  • antacids (may affect the absorption of some anticonvulsants)

Anticonvulsant mood stabilizers are often prescribed for patients who are also taking antidepressants. Generally there are no problems with interactions unless the antidepressant doses are high.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.