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Drugs for Children With Epilepsy

There is a wide number of drugs available for treating epilepsy in children, and advances in the past years have made a difference. In fact, nine new medications have become available in the last decade, says William R. Turk, MD, chief of the Neurology Division at the Nemours Children's Clinic in Jacksonville, Florida.

But that doesn't mean the newest drug for epilepsy is the best. Turk says that while new drugs have helped, there's no single miracle cure responsible for the improvements in treating epilepsy. Instead, doctors are getting better at fine-tuning treatment for each child using new and older drugs. There isn't one right medicine.

Only some of the 20 or so medications used to treat seizures have been approved by the FDA for use in children. Legally, your doctor may prescribe any of the drugs. Still, it's important to be cautious in trying new adult epilepsy drugs in children until there's good evidence that they are safe in younger, small bodies. Discuss your child's options carefully with the doctor.

Types of Epilepsy Drugs

Common drugs for partial or tonic-clonic seizures include Tegretol or Carbatrol (carbamazepine), Dilantin (phenytoin), and Depakote (divalproex sodium). Side effects can include stomach problems or tiredness, and in the case of Dilantin, excess hair growth. For absence seizures, medications include Depakote or Depakene and Zarontin (ethosuximide).

Some of the other drugs used to treat various forms of epilepsy are Neurontin (gabapentin), Topamax (topiramate), Trileptal (oxcarbazepine), Gabitril (tiagabine hydrochloride), Keppra (levetiracetam), Lamictal (lamotrigine), Zonegran (zonisamide), Oxteller XR (oxcarbazepine), and Felbatol (felbamate). Doctors and parents met the arrival of Felbatol on the market several years ago with great excitement. It later turned out that the drug's side effects were more common and more dangerous than previously thought, but it is still a useful medicine for some people.

Some of the anti-seizure medications -- like Depakote -- have been approved as monotherapy for children. This means that it could be the only epilepsy drug your child would take. Many children prefer monotherapy, because they only have to remember to take one pill.

The side effects for these epilepsy medicines vary, but generally they include:

  • grogginess
  • double vision
  • dizziness
  • nausea
  • unsteadiness on the feet
  • rash

Less common side effects of epilepsy drugs include depression, irritability, and hyperactivity. Many epilepsy drugs cause specific side effects, and you should ask your child's doctor about them. Any side effects should be checked out with a doctor. This is especially true of rashes, which could indicate a possibly dangerous allergic reaction to the drug.

How much of a drug should your child take? There isn't a strict rule about this, and it varies with each child. Usually, doctors will try different epilepsy drugs at different doses to determine the best one for your child. Your child should take just enough medicine to prevent seizures without causing side effects. You and your child's doctor may need to tinker with the prescription over a few months to find the right dose. It's worth the effort. Too much medication increases the side effects, while too little leaves your child vulnerable to seizures.

Also, as your child grows, the doctor may adjust the dose of medication (blood levels sometimes help with this decision).

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