I was reading about lamotrigine (Lamictal), an anticonvulsant, and came across a claim (which has been partially verified) that it can cause myoclonic jerks in some cases. Myoclonus can be treated with various drugs, some of which are anticonvulsants. It would make sense to switch a patient to a different anticonvulsant if myoclonic jerks persist, but if treatment with lamotrigine was continued, a second drug could be prescribed to deal with the jerks (although I don't know if this would be wise).

Are there any non-anticonvulsant drugs that have been approved for use specifically with anticonvulsants - not just lamotrigine - to treat myoclonus arising from the use of said anticonvulsants, or are they incompatible for some reason? I'm aware that most drugs used to treat myoclonus are anticonvulsants, but I don't believe that all are (although do correct me if I'm wrong).

1 Answer 1


Treatment of Myoclonus


Caviness JN. Treatment of Myoclonus. Neurotherapeutics. 2014;11(1):188-200. doi:10.1007/s13311-013-0216-3.

This article offers a concise and fairly exhaustive approach to the treatment of Myoclonus of any cause. If you look at Figure 3 (the treatment algorithm), there is a specific pathway for the treatment of drug-induced (Symptomatic) Myoclonus. The actual treatment - and any drugs that might be used - depends on the classification:

cortical; cortical–subcortical; subcortical–nonsegmental; segmental; peripheral.

The ultimate treatment depends on this classification and is outlined in the article. The list of specific medications that may be used - anticonvulsants as well as other medications - is listed in the treatment algorithm.

The medications include:

Levetiracetam, Piracetam, and Related Compounds; Sodium Valproate; Clonazepam; Zonisamide, Primidone, and Miscellaneous Agents (these are not anti-seizure medications)

Of these only a couple are specifically listed as add-on agents:

Primidone and phenobarbital can be useful as add-on therapy

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