•     About Epilepsy
•     Newly Diagnosed
•     Diagnosis
•     Treatment
  •         Medication
  •         Ketogenic Diet
  •         Surgery
  •         Complementary Treatments
  •         Prognosis
•     Syndromes
•     Seizures and Autism
•     Informational Videos
•     Tools You Can Use

Treatment: Medication

Anti-epileptic drugs can help control seizures in most people. These drugs do not actually “fix” the problems that cause seizures; they work by suppressing seizures. Before choosing an anti-epileptic drug, it’s important to do these two things: receive an accurate diagnosis of epilepsy and have an open discussion with your doctor about the pros and cons of the different drugs available.

Again, in most cases epilepsy is treated with medication. Over the past decades new drugs for epilepsy have become available which allow many people with epilepsy to live virtually seizure-free lives. However, as each individual drug is likely to be most effective in controlling only a certain type of epilepsy, the accurate identification of the type of epilepsy is important for the correct choice of drug.

There are a number of different drugs which are commonly prescribed for epilepsy and these may be referred to by the name of the drug itself, (the generic name) or by its trade name (the brand name used by the company which makes the drug). The doctor’s choice of drug may be limited by the fact that perhaps only one or two of these drugs are likely to be effective in controlling a particular type of epilepsy.

Anti-epileptic drugs also come in many different forms – tablets, coated pills, capsules, syrups and liquids. There are many factors that can affect which form the doctor chooses.  For example, an injection of fluid may be preferred when the drug must be taken into the bloodstream quickly, whereas syrups are often used for people who may have difficulty swallowing tablets.

What Do These Medications Do?
Anti-epileptic drugs do not cure epilepsy; they only control it. Some drugs work by making over-active brain cells less excitable and others work by decreasing the brain cells’ ability to transmit abnormal impulses to each other causing a seizure.

Maintaining a roughly constant amount of the appropriate drug in the bloodstream helps control seizures. To achieve this, the prescribed drug must be taken regularly, as near as possible to the times recommended by the doctor. Missed or late doses can reduce the concentration and could result in a seizure, although one missed dose on rare occasions is unlikely to cause any harm.

It is not an easy task for everyone to remember to take the correct dose at the same time each day. If this is a problem it may be helpful to set aside the daily dosage so a check can be made at the end of each day or to use a special drug wallet, which can be bought through a pharmacy.

If you are likely to be away from home occasionally, missing a dose can be avoided by carrying a spare set of medication to cover unexpected circumstances.

When traveling abroad it is wise to take a sufficient supply of medication to cover the period away from home. Anti-epileptic drugs are sold under different trade names in other countries and are not always easily identifiable. However, the generic name is the same in all countries.

Also, carry a copy of your prescription, but if medication is lost it will generally need to be re-prescribed by a doctor in that country, most countries will not permit dispensing on foreign prescriptions.

What Is the Right Amount of Medication for Me?
The most effective amount for controlling seizures varies from person to person. People with newly diagnosed epilepsy should be treated with one drug at a time.  The effectiveness of the drug treatment should be closely monitored and the drug dose altered as warranted in order to achieve complete control of the appropriate and accurate treatment with one drug, a combination of drugs may be tried. However, the drug regime should be kept as simple as possible so as to minimize side effects and encourage compliance.

Monotherapy - single drug treatment for epilepsy.

Polytherapy - treatment with multiple drugs.

For a complete description, visit: Monotherapy vs. Polytherapy

Does Epilepsy Medication Have Side Effects?
Most anti-epileptic drugs are not addictive but they may have side effects. As these drugs act on the brain, drowsiness, sedation, nausea and unsteadiness may occur. Sometimes this occurs when the drug is taken initially and normally wears off. These side effects may also be experienced if the dose is too high. Persistent, unwelcome effects should be brought to the attention of the doctor. Chronic side effects may be experienced with some drugs when taken over a prolonged period.

Pregnant women need particular care, and ideally medication should be reviewed before the pregnancy begins.

UNDER NO CIRCUMSTANCES SHOULD A PERSON STOP TAKING ANTI-EPILEPTIC MEDICATION ABRUPTLY WITHOUT SEEKING MEDICAL ADVICE. TO DO SO COULD PRECIPITATE WITHDRAWAL SEIZURES AND COULD BE DANGEROUS.

Will I Need to Take These Medications For a Lifetime?
For some people the answer is “yes”. However, many people, particularly some children who grow out of the tendency to have seizures, can have their medication withdrawn after a period of being seizure-free (two years, perhaps). Withdrawal of medication should be done gradually and under the supervision of a competent doctor. In many cases this can be done successfully and the seizures do not recur, but unfortunately there is no way at present of predicting accurately in whom the seizures will return.

Precautions with Medications
Most children like to copy adults and may be tempted to copy a parent who takes tablets every day. It is very important that all medication be kept out of the reach of children.

Avoid carrying tablets in glass bottles as these may break during a seizure. Most pharmacists now supply plastic containers.

Alcohol can interfere with the effectiveness of medication and if consumed should only be in moderate amounts.

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Brien J. Smith, director of the Comprehensive Epilepsy Program of the Henry Ford Hospital