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Epilepsy: Medication to treat seizures

For most people with epilepsy, medications are used to control seizures. Although response to drugs can vary with different types of epilepsy medications can successfully control seizures in about 70% of patients. However, they won't cure epilepsy.

An accurate diagnosis of the type of epilepsy (not just the type of seizure, since most seizure types occur in different types of epilepsy) is very important in choosing the best treatment. The type of medication prescribed will also depend on several factors specific to each patient, such as which side effects are tolerated by the patient, other illnesses they may have, and which way of taking medication is acceptable to the person with epilepsy.

Here's a list of some of the most common drugs currently used to treat epilepsy and some of their side effects. It is not exhaustive. The drugs are listed by their generic name. The generic name is the approved name of the drug, but may be produced under different brand names by different manufacturers. There is some controversy about the interchangeability of different brands of the same drug. There are suggestions that different brands of the same generic medication may have a different effect on epilepsy control, so if the brand of your drug is changed (that is, they look different and have a different name) you should discuss this with your doctor.

Carbamazepine

  • Commonly used to treat partial, generalised tonic-clonic and mixed seizures
  • Common adverse effects include fatigue, vision changes, nausea, dizziness, rash

Ethosuximide

  • Used to treat absence seizures
  • Adverse effects include nausea, vomiting, decreased appetite and weight loss

Sodium valproate

  • Used in all forms of epilepsy

The most troublesome side effect is an effect on the liver and liver function tests should be carried out during the first six months of treatment. Other side effects include nausea, gastric irritation, diarrhoea, weight gain, and transient hair loss

Tiagabine

  • Used with other epilepsy drugs to treat partial and some generalised seizures
  • Common side effects include dizziness, fatigue, weakness, irritability, anxiety and confusion. It may also cause a low white blood cell count

Levetiracetam

  • Used with other epilepsy drugs to treat partial seizures and generalised tonic-clonic seizures
  • Side effects include tiredness, weakness, and behavioural changes. It is not recommended for use in children.

Lamotrigine

  • Treats partial and some generalised seizures
  • Has few side effects, but a severe hypersensitivity reaction may occur. Patients should be warned to seek advice immediately if any significant rash occurs. The hypersensitivity reaction is more common in patients who are also taking sodium valproate. Rarely dizziness, insomnia or a low white blood cell count can occur

Pregabalin

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