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Epilepsy is a disorder in which the brain sends abnormal signals, which can lead to seizures. Although seizures can occur for a variety of reasons, such as injury or sickness, epilepsy causes recurrent seizures. There are many types of epileptic seizures. Many of them can be treated with anti-seizure medications.
Anti-seizure medications are also known as antiepileptic drugs (AEDs). According to the National Institute of Neurological Disorders and Stroke (NINDS), there are more than 20 AEDs available through prescription. While there are many options in epilepsy treatment, your therapy choices will depend on your:
- type of seizures
- frequency of seizures
- chances of pregnancy (in women)
Seizure medications are available in two types: narrow- and broad-spectrum AEDs. Some patients may need more than one medication to prevent epileptic seizures more effectively. It’s important to discuss the possibility of side effects, and even worsening seizures, with your doctor before starting any of these medications.
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Part 2 of 3: Narrow-Spectrum AEDs
Narrow-spectrum AEDs are designed for specific types of seizures. These are the most appropriate medications if seizures occur in one specific part of the brain on a regular basis.
Carbamazepine (Carbatrol, Tegretol, Epitol, Equetro)
Carbamazepine is used to treat seizures that occur in the temporal lobe. It may also be helpful in treating secondary, partial, and refractory seizures. It is used for many other purposes, including pain and mood treatment. Carbamazepine interacts with many other drugs.
Clobazam (Frisium, Onfri)
Clobazam helps prevent absence, secondary, and partial seizures. It is a benzodiazepine, a drug class that is often used for sedation, sleep, and anxiety. According to the Epilepsy Foundation, this medication may be used in patients as young as 2 years old. It has recently been linked to a rare but potentially serious skin reaction.
Diazepam (Valium, Diastat)
Used to treat cluster seizures, diazepam can also be used to treat prolonged seizures. Diazepam is a benzodiazepine. It’s also used to treat anxiety, alcohol withdrawal, and more. The product Diastat is used rectally for life threatening seizures.
This medication is approved to help treat complex partial, absence, partial, and multiple seizure types. Divalproex increases availability of gamma-aminobutyric acid (GABA). GABA is an inhibitory neurotransmitter. It may also be helpful for bipolar mania and migraines.
Eslicarbazepine Acetate (Aptiom)
This seizure drug is approved as additional (adjunctive) treatment for partial-onset seizures. Its action is thought to involve blockade of sodium channels.
This AED is used to treat all forms of absence seizures. These also include atypical, childhood, and juvenile absence seizures. Ethosuxemide reduces the likelihood of seizures.
Gabapentin (Neurontin, Gralise, Gabarone)
Glabapentin is used to treat partial seizures. It may be preferable over other AEDs because the potential side effects are mild. The most common are dizziness and fatigue. Gabapentin is also widely used for several pain syndromes.
This medication is used for partial seizures. According to the Epilepsy Foundation, it is approved for patients ages 17 and older. Lacosamide may be prescribed orally or intravenously.
Perampanel is used to treat complex, simple, and refractory seizures. The way it works is not fully understood. The medication is thought to affect glutamate receptors in the brain. Perampanel can cause serious of life-threatening psychiatric or behavioral adverse reactions.
This is one of the first and oldest seizure medications still used in the treatment of epilepsy. It can treat generalized seizures, partial seizures, and tonic-clonic seizures. Phenobarbital is a long-acting sedative drug with anticonvulsant action.
Phenytoin (Dilantin, Phenytek, and others)
Phenytoin is another old and prominent anti-epileptic drug on the market. It stabilizes neuronal membranes. It’s used in the treatment of complex, simple, and refractory seizures. Phenytoin is available in both capsule and liquid form.
This medication is used as additional (adjunctive) treatment for partial-onset seizures. Pregabalin is used more often to treat diabetic neuropathy or fibromyalgia.
This medication is used as additional (adjunctive) treatment of seizures associated with Lennox-Gastaut syndrome. It can cause adverse effects like high rate of heart rhythm changes and drug interactions. These effects limit the use of this drug.
Tiagabine Hydrochloride (Gabitril)
This medication is used as additional (adjunctive) treatment for complex and simple partial seizures.
Oxcarbasepine is used to treat call types of focal seizures. According to Panayiotopoulos, it can be used in adults and children as young as 2 years old.
This medication is used as additional (adjunctive) treatment for complex partial seizures. This medication is restricted in use. It must be prescribed and dispensed by prescribers and pharmacies registered with the program. It comes with possible serious adverse effects, including permanent vision loss.
Part 3 of 3: Broad-Spectrum AEDs
If you have more than one type of seizure, a broad-spectrum AED may be your best choice of treatment. These medications are designed to prevent seizures in more than one part of the brain, as opposed to the focalized effects of narrow-spectrum AEDs.
Clonazepam (Epitril, Klonopin, Rivotril)
Clonazepam is a long-acting benzodiazepine. It’s used to treat multiple types of seizures. This includes myoclonic, akinetic, and absence seizures. Klonopin is the most common brand name. Clonazepam is also used to treat several other non-epileptic disorders.
This AED is used as an additional (adjunctive) treatment. It’s used for generalized seizures, refractory, and complex partial seizures. Ezogabine can cause vision abnormalities that can become vision loss over time. It’s reserved for patients who do not respond to other drugs.
Felbamate is used to treat nearly all types of seizures in people who don’t respond to other therapy. It can be used as single therapy or in combination with other drugs. It is used when other therapies have failed.
This medication may treat a wide range of epileptic seizures. It’s also sometimes used in the treatment of Lennox-Gastaut Syndrome. When you start lamotrigine, your dose is gradually increased. People on this drug must watch for rare skin reactions, which can be serious.
Lorazepam is approved for use in status epilepticus (prolonged, critical seizure). Lorazepam is a benzodiazepine. It’s often used for anxiety and mild sedation, with a rapid onset of action. It’s available in oral tablets, liquid, and injectable forms.
Primidone is used to treat myoclonic, tonic-clonic, and focal seizures. This medication is also approved for the use in juvenile myoclonic epilepsy.
Used as single or in combination treatment for a variety of seizures, topiramate is only available in its brand-name form Topamax. It has several actions. Topiramate is also used to treat migraine. It may also cause headache in some patients.
Levetiracetam is considered first line therapy for generalized and partial seizures, atypical, absence and other types of seizures. According to Panayiotopoulos, this promising drug can be used to treat all focal or generalized, idiopathic, or symptomatic epilepsy in people of all ages. It is also considered one of the drugs most free from adverse reactions.
Zonisamide is used as additional (adjuctive) treatment in partial seizures and other types of epilepsy. This drug has been shown to be effective in treating a range of epilepsy and seizure types. However, it comes with many potentially serious adverse reactions.
Valproic acid is a common AED. It’s approved to treat most seizures on its own or in combination treatment. Valproic acid increases the availability of gamma-aminobutryic acid (GABA). GABA is an inhibitory neurotransmitter to brain neurons. Valproic acid is also used to treat mood disorders or migraine. It is available in the following brands:
- Depakote Sprinkles