Treatment can reduce or prevent seizures in most people who have epilepsy, which can improve the quality of your life. Controlling your epilepsy also lowers the risk of falling and other complications that can happen when you have a seizure.

First your doctor will determine what type of epilepsy and what kinds of seizures you have. Treatment that controls one kind of seizure may have no effect on other kinds. Your doctor will also consider your age, health, and lifestyle when planning your treatment.

It may take time for you and your doctor to find the right combination, schedule, and dosage of medicines to manage your epilepsy. The goal is to prevent seizures while causing as few unwanted side effects as possible. With the help of your doctor, you can weigh the benefits of a particular treatment against its drawbacks, including side effects, health risks, and cost.

After you and your doctor figure out the most effective treatment for you, it is important that you follow your treatment exactly as prescribed.

Initial treatment

Initial treatment for epilepsy depends on the severity, frequency, and type of seizures and whether a cause for your condition has been identified. Medicine is the first and most common approach. Antiepileptic medicines do not cure epilepsy, but they help prevent seizures in well over half of the people who take them.¹

Medicines that may be used first to treat epileptic seizures include:

• Carbamazepine (Tegretol, Carbatrol).
• Ethosuximide (Zarontin), for absence seizures only.
• Topiramate (Topamax).
• Oxcarbazepine (Trileptal).
• Phenytoin (Dilantin, Phenytek) or fosphenytoin (Cerebyx).
• Valproic acid or divalproex sodium (Depakene, Depakote).
• Phenobarbital (Luminal Sodium, Solfoton). Phenobarbital is a first-line medicine for newborns.
• Primidone (Mysoline). The body converts primidone into phenobarbital.

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Taking your epilepsy medicine properly

Other types of treatment may be used along with medicines to better control seizures, such as:

• Ketogenic diet, which is a high-fat diet that has been used with some success to treat people, especially children, who have severe, uncontrolled seizures. Some doctors may not support its use.
• Vagus nerve stimulation. The stimulator device is used with medicine or surgery to reduce seizures.

It is not always clear whether to begin treatment after a first seizure. It is difficult to predict whether you will have additional seizures. Antiepileptic medicines are not usually prescribed unless you have risk factors for having another seizure, such as brain injury, abnormal test results, or a family history of epilepsy.

Ongoing treatment

If epileptic seizures continue even though you are being treated, additional or other antiepileptic medicines may be tried, including:

• Felbamate (Felbatol).
• Gabapentin (Neurontin).
• Lamotrigine (Lamictal).
• Levetiracetam (Keppra).
• Tiagabine (Gabitril).
• Topiramate (Topamax).
• Zonisamide (Zonegran).
• Benzodiazepines (for example, Diastat, Tranxene, Valium).
• Phenobarbital (Luminal Sodium, Solfoton). Phenobarbital is a first-line medicine for newborns.
• Primidone (Mysoline). The body converts primidone into phenobarbital.
• Pregabalin (Lyrica). This medicine is intended to be used along with other antiseizure medicine.