Epilepsy - Treatment Overview
Treatment can reduce or prevent seizures in most people who have epilepsy. This can improve quality of 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 figure out 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 he or she plans 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 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 treatment that works best for you, make sure to 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.
Medicines that may be used first to treat epileptic seizures include:
- Carbamazepine (such as Carbatrol).
- Ethosuximide (Zarontin), for absence seizures only.
- Topiramate (Topamax).
- Oxcarbazepine (Trileptal).
- Phenytoin (Dilantin, Phenytek) or fosphenytoin (Cerebyx).
- Valproate (Depakene, Depakote).
- Phenobarbital (Luminal). Phenobarbital is a first-line medicine for newborns.
- Primidone (Mysoline). The body converts primidone into phenobarbital.
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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 along with medicine or surgery.
It is not always clear whether to begin treatment after a first seizure. It is hard to predict whether you will have more 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:
- Benzodiazepines (such as Klonopin).
- Felbamate (Felbatol).
- Gabapentin (Neurontin).
- Lacosamide (Vimpat). This medicine can be used along with other antiseizure medicine to treat partial seizures.
- Lamotrigine (Lamictal).
- Levetiracetam (Keppra).
- Phenobarbital (Luminal). Phenobarbital is a first-line medicine for newborns.
- Pregabalin (Lyrica). This medicine is intended to be used along with other antiseizure medicine.
- Primidone (Mysoline). The body converts primidone into phenobarbital.
- Rufinamide (Banzel). This medicine can be used along with other antiseizure medicine to treat seizures caused by Lennox-Gastaut syndrome.
- Tiagabine (Gabitril).
- Topiramate (Topamax).
- Zonisamide (Zonegran).
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