Medications for epilepsy

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The first-line treatment for epilepsy is antiseizure medication. These drugs help reduce the frequency and severity of seizures. They can’t stop a seizure that’s already in progress, nor is it a cure for epilepsy.

The medication is absorbed by the stomach. Then it travels the bloodstream to the brain. It affects neurotransmitters in a way that reduces the electrical activity that leads to seizures.

Antiseizure medications pass through the digestive tract and leave the body through urine.

There are many antiseizure drugs on the market. Your doctor can prescribe a single drug or a combination of drugs, depending on the type of seizures you have.

Common epilepsy medications include:

  • levetiracetam (Keppra)
  • lamotrigine (Lamictal)
  • topiramate (Topamax)
  • valproic acid (Depakote)
  • carbamazepine (Tegretol)
  • ethosuximide (Zarontin)

These medications are generally available in tablet, liquid, or injectable forms and are taken once or twice a day. You’ll start with the lowest possible dose, which can be adjusted until it starts to work. These medications must be taken consistently and as prescribed.

Some potential side effects may include:

  • fatigue
  • dizziness
  • skin rash
  • poor coordination
  • memory problems

Rare, but serious side effects include depression and inflammation of the liver or other organs.

Epilepsy is different for everybody, but most people improve with antiseizure medication. Some children with epilepsy stop having seizures and can stop taking medication.

Learn more about the medications used to treat epilepsy »

Is surgery an option for epilepsy management?

If medication can’t decrease the number of seizures, another option is surgery.

The most common surgery is a resection. This involves removing the part of the brain where the seizures start. Most often, the temporal lobe is removed in a procedure known as temporal lobectomy. In some cases, this can stop seizure activity.

In some cases, you’ll be kept awake during this surgery. That’s so doctors can talk to you and avoid removing part of the brain that controls important functions such as vision, hearing, speech, or movement.

If the area of the brain is too big or important to remove, there’s another procedure called multiple subpial transection, or disconnection. The surgeon makes cuts in the brain to interrupt the nerve pathway. That keeps seizures from spreading to other areas of the brain.

After surgery, some people are able to cut down on antiseizure medications or even stop taking them.

There are risks to any surgery, including a bad reaction to anesthesia, bleeding, and infection. Surgery of the brain can sometimes result in cognitive changes. Discuss the pros and cons of the different procedures with your surgeon and seek a second opinion before making a final decision.

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