Understanding Medication Treatment

The aim of treatment is to find the right medication, in the correct dose to reduce or eliminate seizures, so that side effects are minimal or non-existent

• Whenever possible, one medication (mono-therapy) is prescribed
• Sometimes even two or three drugs (poly-therapy) are requires to achieve seizure control
• It is important to follow your medication schedule regularly and carefully
• Your neurologist or physician prescribes the best possible medications or combination of medications based on your type of seizure(s). It may take some time (weeks or even months) to find the right medicine, in the correct dose for your particular type of seizure. It is fairly common for this to happen, but if you know beforehand that the process of finding the right drug may take some time, you may not get discouraged when you don’t achieve immediate success. (from “Medications for Epilepsy”, by the Canadian Epilepsy Alliance, 2001)

Side Effects

All drugs, including anti-seizure medication, have the potential to cause side effects. Many people take anti-seizure medication for years without difficulty. It is important that you talk to your physician about any possible side effects from the prescribed medication. Side effects, which tend to be more common when a drug is just started, or when a dosage is increased, may go away after a few days/weeks. Side effects can be categorized as follow:

• ‘Dose’ related: some side effects are related to the level of the drug in the blood (in other words, the effect will not be present at low doses and low blood levels, but virtually everyone will have the side effect at very high doses and high blood levels). The most common side effects include drowsiness, fatigue, dizziness and loss of coordination
• ‘Allergic’ side effects: these side effects are not directly related to the blood level and are much less common than the dose related effects. Allergic side effects are unpredictable. Examples of this type of side effect include a skin rash, liver trouble or difficulties with the bone marrow. Ask your physician which ‘allergic’ responses you might encounter with your specific medication.

Although the overwhelming majority of medication side effects are not dangerous or permanent, some people with chronic epilepsy worry about the possibility of long-term side effects. Long-term side effects vary from drug to drug and can involve cognitive, renal and liver function. Long term use of some anti-seizure medications can also affect vitamin D and calcium metabolism, with possible effects on bone density (bone thinning). Talk to your physician about ways you can avoid such long term side effects. (from “Medications for Epilepsy”, by the Canadian Epilepsy Alliance, 2001)

Drug Interactions

• Medications for other conditions may interfere with your anti-seizure medication. Always tell your physician, pharmacist or dentist what other medications you are taking.
• Drug interactions may increase or decrease the effectiveness of anti-seizure medications.
• Anti-seizure medications can lessen the effectiveness of birth control pills. Your physician can talk to you about the best possible combination.
• You should be aware that drug interactions can take place with a variety of substances, including some food products, over the counter decongestants, products containing ASA, diet pills, and some herbal medications. (from “Medications for Epilepsy”, by the Canadian Epilepsy Alliance, 2001).

Generic or Brand Name Medications

Anti-seizurec medications come in two forms: ‘brand name’ or ‘generic’

Brand Name medications are made by a research based pharmaceutical company which has a patent on the drug for a certain length of time. When the patent expires, other manufacturers can then produce the drug under a ‘generic’ name.

The active ingredient that helps control your seizures is the same in both ‘brand’ and ‘generic’ names but the substances that are used as fillers, dyes, or binders, sometimes differ. This can occasionally make a difference in how quickly they are absorbed from your stomach or processed by your body. This may affect how much medicine changes your seizure pattern. Talk to your physician or pharmacist. (from “Medications for Epilepsy,” by the Canadian Epilepsy Alliance, 2001).

Helpful Tips for Better Control

• Take medication regularly as prescribed
• Do not try someone else’s pills – ask your physician if that particular pill would help you
• Learn about any side effects of your medication
• Keep medications in a dry place away from direct sunlight
• Keep all medications out of reach of children. Use the drug store bottle with a childproof cap or, if using a pill box, keep it safely out of reach of children. Remember: toddlers can be very curious
• Take enough medication with you when going on vacation. Take your medication with you in its original container. It is also wise to take a prescription from your doctor with you. A reminder: some countries have strict regulations about taking medications into their country, so check first before you go.
• When starting a new anti-seizure medication or when increasing the dose, be careful around machinery or when driving a car, until you know how the new drug will affect you. It may possibly make you drowsy or less alert.
• Ask you physician what to do if you miss a dose of medication- it happens to everyone occasionally. Don’t assume that you can take the missed doses all at once. For epilepsy medication to be effective it needs to be at a constant level in you blood all the time. This is where you can help yourself: taking your medication on a regular basis and at the correct time, it can help you lead a life where you are in control of your epilepsy. That’s a goal worth trying to reach.
•  If you have difficulty in remembering to take you medication, use dome memory aids. Connect taking it to a daily activity such as cleaning your teeth, or eating breakfast (check first to see if your particular medication should be taken before or after meals). Use a monthly calendar, or a weekly pill box, or a wrist watch with an alarm.
•  Do not mix large amounts of alcohol with your medication. Ask your physician if it is safe for you to consume small amounts of alcohol.
• You might want to talk to your physician about the advisability of taking vitamins, calcium, etc. (from “Medications for Epilepsy”, by the Canadian Epilepsy Alliance, 2001).

Anti-epileptic Medications: 

What medications are used in the treatment of epilepsy? Medications are listed by:

Generic medication name (brand name)

“Traditional” Medications:

• Phenobarbital
• Primidone (Mysoline)
• Phenytoin (Dilantin)
• Carbamazepine (Tegretol)
• Valproic Acid (Depakene)
• Divalproex Sodium (Epival)
• Clonazepam (Rivotril)
• Ethosuximide (Zarontin)

“New” Medications:

• Clobazam (Frisium)
• Vigabatrin (Sabril)
• Gabapentin (Neurontin)
• Lamotrigine (Lamictal)
• Topiramate (Topamax)
• Diazepam Rectal Gel (Diastat)
• Levetiracetam (Keppra)

*For more information on these and other anti-epileptic medications contact info@epilepsynl.com / 709-722-0502 / 1-866-Epilepsy toll free.