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Treatment for Epilepsy

What Are the Treatments for Epilepsy?

The majority of epileptic seizures are controlled by medication, particularly anticonvulsant drugs. The type of treatment prescribed will depend on several factors, including the frequency and severity of the seizures and the person's age, overall health, and medical history. An accurate diagnosis of the type of epilepsy is also critical to choosing the best treatment.

Drug Therapy

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Many drugs are available to treat epilepsy, several of which have only recently been released. Although generic drugs are safely used for most medications, anticonvulsants are one category where doctors proceed with caution. Most doctors prefer to use brand name anticonvulsants, but realize that many insurance companies will not cover the cost. As a result, it is acceptable to start taking a generic anticonvulsant medication, but if the desired control is not achieved, the patient should be switched to the brand name drug.

Classic medications used to treat epilepsy include:

  • Dilantin or Phenytek
  • Phenobarbital
  • Tegretol or Carbatrol
  • Mysoline
  • Zarontin
  • Depakene
  • Depakote, Depakote ER
  • Valium and similar tranquilizers, such as Tranxene and Klonopin

Newer drugs to treat epilepsy include:

  • Aptiom
  • Felbatol
  • Fycompa
  • Gabitril
  • Keppra
  • Lamictal
  • Lyrica
  • Neurontin
  • Oxteller XR
  • Topamax
  • Trileptal
  • Vimpat
  • Zonegran

The choice of drug is most often based on factors like the patient's tolerance of side effects, other illnesses he or she might have, and the medication's delivery method.

Although the different types of epilepsy vary greatly, in general, medications can control seizures in about 70% of patients.

Side Effects of Epilepsy Drugs

As is true of all drugs, the drugs used to treat epilepsy have side effects. The occurrence of side effects depends on the dose, type of medication, and length of treatment. The side effects are usually more common with higher doses, but tend to be less severe with time as the body adjusts to the medication. Anti-epileptic drugs are usually started at lower doses and increased gradually to make this adjustment easier. One of the best rules in medicine is to ''go low and go slow.''

There are three types of side effects:

  • Common or predictable side effects. These are common, nonspecific, and dose-related side effects which occur with any epilepsy drug, which affects the central nervous system. These side effects include blurry or double vision, fatigue, sleepiness, unsteadiness, and stomach upset.
  • Idiosyncratic side effects. These are rare and unpredictable reactions which are not dose-related. Most often, these side effects are skin rashes, low blood cell counts, and liver problems.
  • Unique side effects. These are those that are not shared by other drugs in the same class. For example, Dilantin and Phenytek (phenytoin) can cause the gums to swell and Depakene (valproic acid) can cause hair loss and weight gain. Your doctor will discuss any unique side effects before prescribing the medication.
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