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Medications

Anti-Seizure Medications

For over 80 years, the most effective treatment for epilepsy and seizure disorders has been through the use of seizure-preventing medications called anti-convulsion or anti-epileptic drugs (AEDs).

While these medications do not cure epilepsy, they make it possible for many people to live normal, active lives completely free of seizures. Other people may continue to have seizures, but less frequently. And there are still those who need other treatment methods as the drugs are not effective against their seizures.

There is much variability among people and the AEDs they take including side effects and the drug’s effectiveness against their type of seizures. It often takes a good deal of time to find the right medication (mono therapy), or combination of medication (poly therapy), in the right dosage to reach an effective seizure-preventing level in a person.

There are over 20 different anti-epileptic medications available today. Most are effective for only certain types of seizures, so once a diagnosis of epilepsy and its type or types has been made, the doctor will determine which medicine might be most appropriate as a form of treatment. Most types of medications are taken by mouth in the form of tablets or capsules. They may also be prescribed in sprinkles or syrup.

No two people react the same to anti-seizure medications. One drug may effectively control one person’s seizures, while that same drug may not work at all for another. How a body metabolizes anti-seizure medication will play a big part in what dosage levels will be successful in controlling seizures. For some people, side effects can be substantial, while others experience no negative side effects at all. All of these variations, from person to person, mean that it may take a while for you and your doctor to find the right anti-seizure medication at the right dosage level for you.

In most cases, the doctor will begin treatment at a low level of the drug and gradually increase, or titrate, the levels of the drug into your system. Starting at a low level and increasing the dosage over time helps to prevent toxic levels of the drug in your system. This progression also enables the doctor to observe what you can tolerate and at what level the seizures may stop.

Taking medications as prescribed is the most important part of treatment. The medicine you take every day replaces what has been metabolized by your body, keeping the medication levels at the correct therapeutic level in your bloodstream. Skipping a dose, taking fewer pills than prescribed, or not filling your prescription on time can cause your medication level to be too low in your blood, which means that you may experience a seizure. For some people, this can happen within minutes of missing a dosage. Not complying with your prescribed medication dosages is one the biggest reasons for breakthrough seizures and/or status epilepticus.

All medications can cause side effects. Some of these are acceptable and some are not. It is possible that after awhile, some side effects may simply go away. Side effects can happen because anti-seizure medication is interacting with another drug being taken, so always inform your doctor of other medicines you are using. Anti seizure medication may build up in the body, reaching a toxic level. If you are experiencing any side effects, such as nausea, fatigue, staggering, slurring of words, or a rash, contact your doctor immediately.

It is important to remember that these medications will only work if they are taken regularly, every day! To help the medicine work, here are some suggestions:

  • Take the medicine at the same time every day;
  • Take the exact amount of medicine that the doctor has said–changing your dose on your own might cause you to have a seizure;
  • If medicine is a liquid, shake the bottle well before you pour the dose to ensure that the medication is properly distributed in the liquid;
  • Keep your medicines in a cool, dry place, out of children’s reach;
  • Report any side effects and seizure activity to your doctor, he may want to try a different dose or a different medication altogether;
  • Ask your doctor ahead of time what to do if you miss a dose of medication;
  • Don’t run out of medication–renew your prescription in a timely manner so you always have at least a week’s supply on hand;
  • Ask your doctor ahead of time if there are any over-the-counter medicines (ex: cold pills, pain medicines), herbal products, vitamins or dietary supplements that you should not take because you take epilepsy medication;
  • Be careful when consuming alcohol–check with your doctor about how it may mix with your medicine;
  • Get enough sleep–lack of sleep is thought to trigger seizures.

Some common medicines for epilepsy include:

  1. Aptiom (Brand name)/ Eslicarbazepine (Generic). Some side effects: dizziness, drowsiness, nausea, headache, double vision, vomiting, fatigue, loss of coordination.
  2. Ativan (Brand name)/Lorazepam (Generic). Some side effects: drowsiness, sleepiness, fatigue, poor coordination, unsteadiness, behavior changes
  3. Banzel (Brand name)/Rufinamide (Generic). Some side effects: headache, dizziness, fatigue, sleepiness, double vision, tremors, hypersensitivity syndrome, fever, rash, fluid accumulation, swollen lymph nodes, liver injury and confusion
  4. Carbatrol (Brand name)/Extended Release Carbamazepine (Generic). Some side effects: dizziness, drowsiness, blurred or double vision, nausea, skin rashes, abnormal blood counts (rare)
  5. Depakene (Brand name)/Valproate (Generic), introduced in 1978. Some side effects: upset stomach, altered bleeding time, liver toxicity, hair loss, weight gain, tremor
  6. Depakote (Brand name)/Divalproex Sodium (Generic). Some side effects: upset stomach, altered bleeding time, liver toxicity, hair loss, weight gain, tremor
  7. Diamox (Brand name)/Acetazolamide (Generic). Some side effects: appetite loss, frequent urination, drowsiness, confusion, numbness of extremities, kidney stones
  8. Dilantin (Brand name)/Phenytoin (Generic), Phenytek (extended release):introduced in 1938. Some side effects: clumsiness, insomnia, motor twitching, nausea, rash, gum overgrowth, hairiness, thickening of features
  9. Felbatol (Brand name)/ Felbamate (Generic), introduced in 1993. Some side effects: anorexia, vomiting, insomnia, nausea, headache, liver and blood toxicity
  10. Gabitril (Brand name)/Tiagabine (Generic), introduced in 1997. Some side effects: tremors, dizziness, nervousness, difficulty concentrating, sleepiness, weakness
  11. Keppra (Brand name)/Levetiracetam (Generic). Some side effects: sleepiness, fatigue, poor coordination, loss of strength, dizziness
  12. Klonopin (Brand name)/Clonazepam (Generic), introduced in 1975. Some side effects: drowsiness, sleepiness, fatigue, poor coordination, unsteadiness, behavior changes
  13. Lamictal (Brand name)/Lamotrigine (Generic), introduced in 1994. Some side effects: dizziness, headache, blurred vision, clumsiness, sleepiness, nausea, skin rash
  14. Lyrica (Brand name)/Pregabalin (Generic).Some side effects: dizziness, somnolence, ataxia, neurasthenia, weight gain
  15. Mysoline (Brand name)/Primidone (Generic), introduced in 1954. Some side effects: clumsiness, dizziness, appetite loss, fatigue, drowsiness, hyper-irritability, insomnia, depression, hyperactivity (children)
  16. Neurontin (Brand name)/Gabapentin (Generic), introduced in 1993. Some side effects: sleepiness, dizziness, clumsiness, fatigue, twitching
  17. Onfi  (Brand name)/Clobazam (Generic), FDA approval in June of 2011. Some side effects: somnolence, sedation, drooling, constipation, cough, dysphagia, fatigue, *Stevens Johnson Sydrome.
  18. Potiga (Brand name)/Ezogabine (Generic),Some side effects: suicidal thoughts, dizziness, vertigo, fatigue, confusion, tremors, double vision, memory problems, alertness, problems with coordination, increased urinary retention
  19. Phenobarbital (Brand name)/Phenobarbital (Generic), introduced in 1912. Some side effects: drowsiness, irritability, hyperactivity (children), behavioral problems, difficulty concentrating, depression
  20. Phenytek (Brand name)/Extended Phenytoin Sodium (Generic). Some side effects: clumsiness, insomnia, motor twitching, nausea, rash, gum overgrowth, hairiness, thickening of features
  21. Sabril (Brand name)/Vigabatrin (Generic). Some side effects: sleepiness, headache, dizziness, nervousness, hyperactivity in children
  22. Tegretol (Brand name)/Carbamazepine (Generic), introduced in 1974. Some side effects: dizziness, drowsiness, blurred or double vision, nausea, skin rashes, abnormal blood counts (rare)
  23. Tegretol XR (Brand name)/Extended Release Carbamazepine (Generic). Some side effects: dizziness, drowsiness, blurred or double vision, nausea, skin rashes, abnormal blood counts (rare)
  24. Topamax (Brand name)/Topiramate (Generic), introduced in 1996. Some side effects: confusion, sleepiness, dizziness, clumsiness, difficulty thinking or talking, tingling sensation of the skin, nausea, decreased appetite
  25. Tranxene (Brand name)/Clorazepate (Generic), introduced in 1981. Some side effects: drowsiness, sleepiness, fatigue, poor coordination, unsteadiness, behavior changes
  26. Trileptal (Brand name)/Oxcarbazepine (Generic). ** Oxitellar is a once a day medication. Some side effects: difficulty concentrating, sleepiness, fatigue, dizziness, double vision, nausea, unsteadiness, rash
  27. Vimpat (Brand name)/Lacosamide (Generic). Some side effects: dizziness, headaches, nausea, vomiting, double vision, sleepiness, fatigue, unsteadiness, shakiness, memory loss, mood changes, electrocardiogram changes
  28. Zarontin (Brand name)/Ethosuximide (Generic), introduced in 1960. Some side effects: appetite loss, nausea, drowsiness, headache, dizziness, fatigue, rash, abnormal blood counts (rare)
  29. Zonegran (Brand name)/Zonisamide (Generic). Some side effects: sleepiness, dizziness, loss of appetite, headache, nausea, irritability, difficulty concentrating, unsteadiness, fever, kidney stones, rash (should not be used in individuals allergic to sulfa drugs)

The following medicine is not prescribed for daily, long-term use, but to stop episodes of prolonged or cluster seizures:

Diastat (Brand name)/Diazepam Rectal Gel (Generic). Some side effects: drowsiness, sleepiness, fatigue, poor coordination, unsteadiness, behavior changes

For a comprehensive up to date drug guide, follow this link to www.epilepsy.com.  You will be connected to a searchable database to any and all drugs that are associated with epilepsy. Brand names and their generics, treatments, seizure types, and even the appearance and dosage of the drugs can be found.