Epilepsy is a brain disorder that causes repeated episodes of unprovoked seizures. There is no cure for epilepsy, but medications may help keep symptoms under control. Epilepsy is almost always treated first with medication.
Choosing the right one, however, can be challenging. There are at least 20 different drugs available to prevent seizures. Some have been around for decades. Many others have only been developed recently, and each drug comes with its own benefits and risks. Also, side effects and dosing schedules vary from drug to drug.
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The ultimate goal of treatment is to establish control and be free from seizures. But sometimes, even after control has been established, people may still have a seizure, often referred to as a breakthrough seizure.
To help determine which medication you should try first, your doctor will carefully review your medical history and lifestyle. It's important to remember that epilepsy treatment is tailored to the individual. What works for you may not work for someone else. And some people may need to take more than one medication.
What Are Epilepsy Medications?
Your doctor or nurse may refer to epilepsy medications as antiepileptic drugs or AEDs. Other names used are anticonvulsants or antiseizure drugs. Sometimes the drugs are just called seizure drugs. These medications help suppress the faulty signaling in the brain that leads to seizures. You must take epilepsy medication every day as directed, even when you aren't having symptoms. Some people need to take epilepsy medication for life.
The goals of using medications to treat epilepsy include:
Having no or few seizures
Having no or few side effects
Using only one epilepsy medication, called monotherapy
Choosing the Right Epilepsy Medication
Which epilepsy medication is best for you depends on many factors, including:
Type of epilepsy. There are different forms of epilepsy, and each may cause a different type of seizure. It's very important that your doctor determine what type of epilepsy you have. Not all medications work on all types of seizures. And, sometimes, an epilepsy medication can make seizures worse. If your doctor can't determine what type of seizures you have, you may be prescribed what's known as a "broad-spectrum" epilepsy medication. Broad-spectrum means it can work on a wide range of seizures.
Other health issues and risks. You may have other medical conditions that dictate which epilepsy medications you can or cannot safely take. For example, liver and kidney disease may alter the levels of epilepsy medication in your bloodstream. Your doctor may also consider your risk of osteoporosis before prescribing an epilepsy drug. Some epilepsy drugs can cause bone loss and lead to osteoporosis. A vitamin D supplement may be needed. Menopause and other hormone changes can also affect the choice of epilepsy medication.
Pregnancy. Some epilepsy medicines can harm an unborn baby. For example, valproate is not recommended for women in their child-bearing years. The medicine is known to interfere with the growth and development of a baby in the womb and has been linked to birth defects. Other drugs may also have some risk of birth defects. Having seizures while pregnant also poses serious risks including miscarriage, trauma related to falling, and lack of oxygen to the fetus. Pregnancy itself can affect how your body breaks down an epilepsy drug. And that can put you at risk for breakthrough seizures or side effects. If you are pregnant or planning to become pregnant, talk to your doctor as soon as possible. You may need to change your medication or adjust your dose. Never stop taking your medication without first talking to a doctor.