Treating Epilepsy: Medicines
If you’ve been diagnosed with epilepsy, your healthcare provider will create a treatment plan for you. Medicines called antiepileptic drugs (AEDs) are the primary treatment for epilepsy. These medicines greatly reduce or prevent seizures in most people who take them. For some people, other treatment choices may be available. Treating epilepsy can be difficult when medicine is not keeping seizures under control (refractory epilepsy), or when medicines have harsh side effects. It can also be difficult to treat epilepsy in pregnant women.
Your medicine plan
Your healthcare provider will work with you to create the best medicine plan for you:
Type of medicine. There are many types of AEDs. The first type you try will likely help you. If not, your healthcare provider may suggest another type, or a combination of AEDs. If you plan to become pregnant or are already pregnant, your medicines might need to be adjusted by your provider to protect your developing baby.
Dosage. You will probably be started at a low dosage. The dosage will be slowly increased until your seizures are better controlled or a target dosage is reached.
Rescue medicines. Your treatment plan may include special medicines to stop seizures. They can be given to you during a seizure only by someone who has been specially instructed by a healthcare provider.
After you start taking medicines, you may have follow-up testing. These tests measure the level of medicine in your blood. Eventually, you’ll need to have these tests from time to time. But certain medicines don’t require lab testing. Your healthcare provider may also need to check certain blood tests to watch for side effects while on AEDs.
When taking epilepsy medicines
DO take your medicines exactly as directed.
DO keep a current list of all medicines you’re taking and show it to your healthcare provider. Make sure you show the list and ask about interactions with any healthcare provider prescribing new medicine for you.
DO know that certain epilepsy medicines can interfere with how birth control pills work.
DO store pills in a cool, dry place (not in the bathroom).
DON’T stop taking your medicines, skip a dose, or change your medicine amount without your healthcare provider’s approval.
DON’T change brands of medicine (usually generic medicines are OK), or even forms of 1 brand (from tablet to liquid, for instance), without your healthcare provider's approval.
DON’T take herbal supplements or antacids without talking to your healthcare provider first. Ask your pharmacist about taking over-the-counter medicines.
Possible side effects of epilepsy medicines
Epilepsy medicines often have effects that are not intended (side effects). Most of these effects go away after a few weeks. The most common side effects of epilepsy medicines include:
Weight gain or loss
Allergic reaction such as a rash or fever
Other treatments for epilepsy
Brain surgery. Brain surgery may sound scary, but it may be a choice if you are still having seizures while on medicine. It can greatly reduce or get rid of seizures, without causing loss of function. It impacts small parts of your brain that cause seizures, leaving the rest of your brain unharmed. In most cases, only people whose seizures start as partial seizures can have the procedure.
Vagus nerve stimulation (VNS). A device is placed under the skin in your chest. The device is connected to a nerve in your neck called the vagus nerve. The device sends electrical impulses through your vagus nerve to your brain. The impulses have been shown to help reduce seizures.
Brain stimulation. A newer device is now available to stimulate a part of the brain to prevent a seizure from spreading. This is not for all types of seizures and only for adults with epilepsy.
December 09, 2017
Evaluation and management of elevated intracranial pressure in adults. UpToDate., Management of epilepsy and pregnancy. UpToDate., Overview of the management of epilepsy in adults. UpToDate.
Fetterman, Anne, RN, BSN,Image reviewed by StayWell art team.,Jasmin, Luc, MD