Drug treatment for epilepsy

Epilepsy is usually treated with anti-epileptic drugs (AEDs), and many people have their seizures successfully controlled in this way.

A number of different medicines can be used, and some are more suitable for specific types of seizures than others. The most appropriate drug for an individual depends on their seizure type, possible epilepsy syndrome, age, gender, if they have other illnesses (co-morbidities) and other medication they are already taking. But individuals also differ greatly in what suits them: a drug that is effective in one patient may be useless in another.

Most people will have their seizures controlled by one anti-epileptic drug. Where this does not work, more than one drug may be needed in order to control seizures.

People's reactions to anti-epileptic drugs can vary enormously. If the drug does not control the seizures, or if a person has side effects that are unacceptable, another drug might be tried. How long it will take to gain control of the seizures varies from person to person. Some people we interviewed explained how their seizures stopped as soon as they started drug treatment for epilepsy. Others reported that it took much longer. Many of these men and women discussed how doctors monitored their drug treatment. This involves doctors checking the control and frequency of seizures, drug levels and side effects.

Prescribing drugs for epilepsy may involve trial and error until the right drug(s) and dosage(s) is found. Many people who were going through this discussed their experiences. While some people were patient during this time, others felt disappointed and frustrated. Some described a complete change of medication as their seizures worsened.

One woman, whose son had severe poorly controlled epilepsy, described the drug changes he'd had over the years, as well as trying different diets. Occasionally people felt that their medication was no longer working as well as it once did, and some wondered if they had become 'tolerant' of it, although there is no scientific evidence to suggest this can occur with the modern drugs.

Some people explained how they monitored the effects of their anti-epileptic drugs themselves before consulting their doctors. One woman, whose husband had epilepsy, explained how different drugs affected him.

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Many of those interviewed described how the doctor gradually changed their drugs. Some discussed how one drug was slowly reduced while a new one was introduced. Others explained how the dosage of a particular drug was altered so that they would be on the lowest effective dose.

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For most of the people we interviewed quality of life was an important concern (see 'Side effects'). Some people noted how a change in medication eventually improved their quality of life. Others discussed the long-term effects of anti-epileptic drugs, and questioned the effects of anti-epileptic medication and the risks of osteoporosis.

Many anti-epileptic drugs can affect each other as well as other medications, including some types of contraceptive pill. All anti-epileptic drugs may have adverse effects on a developing baby (see 'Women and epilepsy').

Last reviewed May 2016.
Last updated May 2016.


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