Epilepsy is a common neurological disorder that can occur at any age, and treatment with antiepileptic drugs (ADEs) is still the treatment of choice. Unlike other diseases, ADEs must be treated with regular, long-term medication under the guidance of a specialist. With the widespread use of antiepileptic drugs in clinical practice, their safety has become increasingly important to specialists. Patients and their families are also concerned about the safety of ADEs. The commonly used ADEs are phenytoin sodium (PHT), carbamazepine (CBZ), phenobarbital (PB), sodium valproate (VPA) and other traditional drugs, as well as new drugs such as Tolteraz (TPM) and lamotrigine (LTG). In clinical practice, common adverse reactions (ADRs) to antiepileptic drugs include rash, abnormal liver function, dizziness, drowsiness, inattention, and abnormal blood cells. The most common ADRs are skin and adnexal damage, followed by digestive system damage and neurological damage: 1. AEDs causing skin and adnexal damage are mainly carbamazepine, sodium valproate, oxcarbazepine and lamotrigine. Carbamazepine, oxcarbazepine, lamotrigine and other drug classes belong to the aromatic group of antiepileptic drugs, and correlate with HLA-B*1502 allele positivity, which seriously manifests as erythema multiforme, maculopapular epidermal necrotizing rash, exfoliative dermatitis and other skin damage and severe liver function damage; 2, AEDs causing digestive system damage are mainly sodium valproate, which mainly manifests as abnormal liver function, nausea, vomiting, constipation, abdominal discomfort, and abdominal discomfort. Nausea and vomiting, constipation and diarrhea, and even pancreatitis, which are inseparable from its metabolism in the liver. Therefore, liver function should be monitored regularly before and after treatment with sodium valproate. 3, the highest proportion of AEDs causing neurological damage is mainly clonazepam, etc., because it is benzodiazepines, and easy to pass the blood-brain barrier, easy to cause central nervous system adverse reactions: dizziness, drowsiness, inattention, reduced learning ability, etc.. 4, hematological system damage, occasionally seen in sodium valproate, carbamazepine caused hematocrit. 5.Carbamazepine treatment may lead to atrioventricular block, and lacosamide and oxcarbazepine treatment may lead to complete block. 6.Electrolyte disorders: hyponatremia, etc. 7. Failure of oral contraceptive drugs, teratogenicity, etc.: For women of childbearing age, if antiepileptic drugs such as lamotrigine and carbamazepine with hepatic enzyme induction are to be used, the use of oral contraceptive drugs needs to be carefully questioned, which may lead to contraceptive failure. Considering the teratogenic effects of antiepileptic drugs, valproate should be avoided before pregnancy. Therefore, it can be seen that antiepileptic drugs are also a “double-edged sword”, and the only way to minimize the incidence of adverse reactions is to control seizures to the greatest extent possible. The prerequisite for successful treatment of epilepsy is correct diagnosis, reasonable typing and selection of drugs according to seizure type. In order to reduce the incidence of ADRs, the indications and doses of drugs should be strictly controlled for children, elderly patients, allergic patients and special patients such as pregnant and lactating women, and the necessary indicators such as liver function and blood count should be monitored. 3, the use of AEDs should pay attention to the small dose to start, slowly increase the dose, for the traditional AEDs, most need to regularly monitor the blood concentration and timely adjustment of dose, according to individualized administration; 4, in the application of AEDs in the process of adverse reactions, as appropriate, dose reduction, discontinuation or replacement of drugs, and for the symptoms of adverse reactions to carry out standardized symptomatic treatment, such as anti-allergic, hepatoprotective, leukocyte, etc. The treatment of AEDs can promote the rational clinical use of AEDs. 5. If adverse reactions occur during the application of AEDs, patients with epilepsy should seek timely follow-up with epilepsy specialists for timely communication and feedback, early detection and early intervention to minimize the occurrence of adverse reactions.