People taking<unk>  should be aware of the following risks: *Avoid activities requiring mental alertness and coordination until drug effects are realized.<unk>  may impair heat regulation, especially in children. Use caution with activities leading to an increased core temperature, such as strenuous exercise, exposure to extreme heat, or dehydration.<unk>  may cause visual field defects.<unk>  may decrease effectiveness of oestrogen-containing oral contraceptives. *Taking<unk>  in the first trimester of pregnancy may increase risk of cleft lip/cleft palate in infant. *As is the case for all antiepileptic drugs, it is advisable not to suddenly discontinue<unk>  as there is a theoretical risk of rebound seizures. Frequency Adverse effects by incidence: Very common (>10% incidence) adverse effects include: Common (1-10% incidence) adverse effects include: * Weight gain * Anaemia * Disturbance in attention * Memory impairment * Amnesia * Cognitive disorder * Mental impairment * Psychomotor skills impaired * Convulsion * Coordination abnormal * Tremor * Lethargy * Hypoaesthesia (reduced sense of touch) * Nystagmus * Dysgeusia * Balance disorder * Dysarthria * Intention tremor * Sedation * Blurred vision * Diplopia (double vision) * Visual disturbance * Vertigo * Tinnitus * Ear pain * Dyspnoea * Epistaxis * Nasal congestion * Rhinorrhoea * Vomiting * Constipation * Abdominal pain upper * Dyspepsia * Abdominal pain * Dry mouth * Stomach discomfort * Paraesthesia oral * Gastritis * Abdominal discomfort * Nephrolithiasis * Pollakisuria * Dysuria * Alopecia (hair loss) * Rash * Pruritus * Arthralgia * Muscle spasms * Myalgia * Muscle twitching * Muscular weakness * Musculoskeletal chest pain * Decreased appetite * Pyrexia * Asthenia * Irritability * Gait disturbance * Feeling abnormal * Malaise * Hypersensitivity * Bradyphrenia (slowness of thought) * Insomnia * Expressive language disorder * Anxiety * Confusional state * Disorientation * Aggression * Mood altered * Agitation * Mood swings * Anger * Abnormal behaviour Rarely, the inhibition of carbonic anhydrase may be strong enough to cause metabolic acidosis of clinical importance. The U.S. Food and Drug Administration (FDA) has notified prescribers that<unk>  can cause acute myopia and secondary angle closure glaucoma in a small subset of people who take<unk>  regularly. The symptoms, which typically begin in the first month of use, include blurred vision and eye pain. Discontinuation of<unk>  may halt the progression of the ocular damage and may reverse the visual impairment. Preliminary data suggests that, as with several other anti-epileptic drugs,<unk>  carries an increased risk of congenital malformations. This might be particularly important for women who take<unk>  to prevent migraine attacks. In March 2011, the FDA notified healthcare professionals and patients of an increased risk of development of cleft lip and/or cleft palate (oral clefts) in infants born to women treated with Topamax<unk>  during pregnancy and placed it in Pregnancy Category D.<unk>  has been associated with a statistically significant increase in suicidality, and "suicidal thoughts or actions" is now listed as one of the possible side effects of the drug "in a very small number of people, about 1 in 500."
Topiramate
Lamotrigine
Felbamate
Cenobamate
Propazepine
Tetrabamate
Tiagabine
Mesuximide