Anti-epileptic therapy currently enables over 70% of people with epilepsy to live seizure free lives.

why are drugs prescribed?

The purpose of drug treatment is to control {rather than cure} epilepsy by preventing seizures without producing undesirable side effects. Reaching the balance may take several months or even longer. During this period, you may experience adverse symptoms that can make you loose heart and sometimes control of seizures will never be fully gained.

It is important for you to continue with the treatment and to keep a careful note of the incidence of seizure and side effects. This record will help your doctor make the best decision, particularly with regards to changing the dose or trying another drug.

are Drugs the only treatment for epilepsy?

Anti-epileptic drugs {AEDs} are the mainstay of treatment for epilepsy. Occasionally, in young children with very severe epilepsy, a special diet may be helpful. For some people surgery may be advised.

what are the most common AEDs?

The following drugs listed alphabetically by their chemical name {manufacturers name in brackets} are commonly prescribed:

Acetazolamide {Diamox}

Carbamazepine {Tegretol} {Teril}{Timonil}

Clobazam {Frisium}

Clonazepam {Rivotril}

Ethosuximide {Zarontin} {Emeside}

Paraldehyde

Phenobarbital

Methylphenobarbital {Prominal}

Phenytoin {Epanutin}

Piracetam {Nootropil}

Primidone {Mysoline}

Sodium Valproate {Epilum} {Convulex}

Rectal Diazepam Stesolid}

Vigabatrin {Sabril}

how about new drugs?

Over the past few years the following 5 new drugs have been launched in the UK:

Tiagabine {Gabatril}

Lamotrigine {Lamictal}

Gabapentin {Neurontin}

Topiramate {Topimax}

Oxcarbazepine

These are mainly used as additional treatments - that is, they are taken in conjunction with other AEDs by people who are still experiencing seizures despite receiving one or more of the established drugs. Because they are new it is likely that all their side effects are still unknown, but they may have fewer adverse effects than the older drugs. Although they cost more than older drugs, they can be effective in some cases and they represent hope for the future.

how do AEDs work?

AEDs are absorbed into the body and carried to the brain where they help to prevent the tendency of developing the ‘electrical storm’ that create seizures. Control is helped by maintaining a relatively constant amount of medication in the blood stream throughout the day and night. Missed doses reduce the level of medication in the blood and can result in more seizures. The same amount of drug must therefore be taken each day, whereas the exact timing of each dose is not as important.

what about side effects?

AEDs are not addictive, but may cause effects such as tiredness, double vision, nausea, headache, weight gain {occasionally loss}, temporary hair loss, skin rash, swollen gums, tremor of the fingers and unsteadiness.

Some adverse effects can be minimised by adjusting the dose of the medication. Good dental hygiene can prevent swollen gums. Correct timing of doses can ensure that tiredness occurs only at night. Watching your diet will help to avoid weight gain. The appearance of a skin rash should be reported immediately to your doctor.

Women who take anti-epileptic drugs and wish to use some form of oral contraception should seek medical advice as many AEDs can reduce the effectiveness of the contraceptive pill. Exemptions to this are Sodium Valproate, Clonazepam, Lamotrigine and Gabapentin. Women taking AEDs and who are considering becoming pregnant should seek pre conceptual counselling.