Half of people with newly diagnosed epilepsy will become seizure-free with the first epilepsy drug they try. For the rest, it's try, try again: You switch epilepsy medications, adjust to side effects, and wait to see if the new drug works. Or you might get your seizures under control but find you can’t handle the drug’s side effects.
Before you ask your doctor about a switch, make sure you’re taking the current medicine exactly as prescribed. Missing doses, splitting pills, or not following instructions to the letter could make a difference. It can affect your control over seizures or side effects. If you’re following directions to a T but you still have breakthrough seizures, talk to your neurologist or epileptologist (an expert in treating epilepsy). She’ll decide if you should switch medications.
One possible option for some children with epilepsy is surgery. You may be frightened by the idea of your child having brain surgery, a treatment reserved for a select few, but improvements have made these operations much safer and more effective.
"In the old days, doctors would wait 20 years before trying surgery in a person with epilepsy who didn't respond to medication," says William R. Turk, MD, chief of the Neurology Division at the Nemours Children's Clinic in Jacksonville, Florida. "That...
Over time, most people become seizure-free with minimal side effects while taking epilepsy drugs. But switching meds takes time and patience. Finding the right drug for you can require equal parts art and science -- and sometimes a bit of luck.
A Leap of Faith
Even the best doctors don't know which drug will work best for any given person.
As part of managing the condition, your doctors will try to get a sense of the full picture: your type of seizures, your age and gender, other medical conditions, medicines you're on or may be on later, and epilepsy drugs you've tried in the past.
Based on that information, she may narrow down the field to a few drugs to try. But after that, it's an educated leap of faith.
Where Do You Start?
What does the switching process involve? It will be different for each person. One common factor: Success depends on a good partnership between you and your doctor. Switching meds may include these steps:
1. Choose a new drug. Your doctor will work closely with you to decide on the next drug to try. That includes a detailed discussion about the pros and cons of the medicine, its likely side effects, and any rare but potentially serious effects. If you're a young woman, now is the time to discuss any plans for pregnancy. Some medications interact with birth control pills. And women of childbearing age who take seizure medications should also take daily folate supplements. The more you're involved in choosing your epilepsy drug, the better the chances for long-term success.