A database of medications used for epilepsy
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Treatment Options: Medications
There is no cure for epilepsy, yet. Medications do not cure epilepsy in the same sense that penicillin can cure an infection. For many people with epilepsy, however, the medication will prevent seizures as long as they are taken regularly; but, successful drug therapy requires the active cooperation of the patient. Antiepileptic drugs successfully prevent seizures in the majority of people who take them regularly and as prescribed. It has been estimated that at least fifty percent of all patients with epilepsy gain complete control of their seizures for substantial periods of time. Another twenty percent enjoy a significant reduction in the number of seizures. If patients, in collaboration with their physicians, decide to attempt withdrawal from medications, they should be aware that the seizures may recur and should closely observe seizure precautions. Some individuals, however, have an excellent chance of remaining seizure free without medication in the future.
Unfortunately, some people continue to have seizures regularly despite taking medication. For them, surgical or, in children, dietary therapy with the ketogenic diet may be helpful. There is also hope that continuing research will produce new drugs and new ways of using them that will eventually give seizure relief to everyone who has epilepsy. The Epilepsy Foundation continues to fund basic and clinical research in the field of epilepsy and seizure disorders, and is looking forward to the time when a cure for these conditions will be achieved.
Most epilepsy medicines are taken by mouth. The doctor's choice of which drug to prescribe depends on what kind of seizure a person is having. People react to medicines in different ways. Some experience side effects, others may not. Some people's seizures will respond well to a particular drug while someone else will have seizures that continue. It may take some time to find exactly the right dose of the right drug for each person with epilepsy.
Whenever possible, doctors try to prevent seizures with a single medication. This is called monotherapy. However, some people may require polytherapy, the use of more than one medication to achieve seizure control.When selecting a drug, your doctor will consider the type of seizures you have. Not all medications work for all types of seizures.
Like all drugs, epilepsy medicines have side effects. Some are dose-related, and become more likely as the dose increases.
Intractable: Seizures that do not respond to medications. Thirty percent of people with epilepsy have these kinds of seizures. Also known as "drug resistant." The International League Against Epilepsy (ILAE) defines drug resistant epilepsy as "a failure of adequate
Reference: Kwan P., et al, Definition of resistant epilepsy. Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia. DOI: 10.1111/j. 1528-1167.2009.02397.x
Most authors report that antiepileptic drugs provide complete control for more than half of all patients with epilepsy, and reduce the number of seizures in another 20 to 30 percent. The remaining 20 percent do not respond to current medications and their condition is termed "intractable" or "refractory to treatment." Some of these people may have other treatment options, such as surgery, or (in children) the ketogenic diet.
Reports in the medical literature suggest between 75 and 80 percent of patients with idiopathic, generalized epilepsy have reliable, long term control of seizures on currently available drugs. Some patient surveys, however, show larger percentages of people continuing to have seizures, although they may describe their condition as being under control. Selection bias (clinic-based survey respondents may be more severely affected) may have some bearing on these different results; also, physicians and patients may have different interpretations of control.
Compliance is a term which describes the degree to which the person with epilepsy (or the parent of a child with epilepsy) follows the physician's directions on how and when medicine should be taken, and (sometimes) on what kinds of lifestyle changes should be made.