Medical Treatments for Epilepsy and Seizure Disorders
In patients with epilepsy, the first line of treatment is anti-epileptic medication. Anti-epileptic medication can significantly reduce the frequency and severity of seizures. Fortunately, more than half of patients become seizure free with medication.
Your doctor will suggest the best medication for you based on the seizure type, ease of use, potential side effects, interaction with other medication, and potential impact on other medical conditions. Special consideration in the choice of medication is given to women of childbearing age and older patients.
Medications are increased gradually to the maximum dose that does not cause serious side effects. Additional medications can be prescribed if seizures continue to occur. Common epilepsy medications include:
- Carbamazepine (XR)
- Divalproex Sodium (ER)
- Eslicarbazepine Acetate
- Levetiracetam (XR)
- Tiagabine Hydrochloride
- Topiramate (XR)
- Valproic Acid
A complete list of medications to treat epileptic seizures include can be found at the Epilepsy Foundation Website.
Medications not yet approved by the Food and Drug Administration (FDA) may be available to subjects who participate in research clinical trials. Clinical trials are conducted to study the safety and effectiveness of new medications. Patients interested in clinical trials should discuss this with their physician.
Non-Drug Treatment (frequently used in combination with medications)
- Psychosocial support: Such as counseling, education and emotional support.
- Lifestyle modifications: Such as diet, smoking cessation and exercise.
- Treatment of pre-existing behavioral conditions: Such as addiction, anxiety and depression.
- Treatment of pre-existing medical conditions: Such as diabetes, hypertension and thyroid disease.
- Management of reproductive issues: Some of which may increase seizures or interfere with anti-epileptic medications, such as menstruation, fertility, contraception, pregnancy and menopause.
Approximately 30 percent of patients continue to have seizures despite being on seizure medication. These patients warrant a thorough evaluation of their epilepsy including a number of additional diagnostic studies to see if they may benefit from other treatment options beyond medication, possibly including dietary therapy and/or surgery.
National Association of Epilepsy Centers: Guidelines for where to get the best care for your epilepsy
National Association of Epilepsy Centers:
- Level 1: Epilepsy care provided by ER physicians or primary care providers
- Level 2: Epilepsy care provided by a general neurologist
- Level 3: Epilepsy care provided by neurologists with special training in epilepsy
- Provides a range of medical, neuropsychological, and psychosocial services
- Northwestern Medicine Central DuPage Hospital is a Level 3 Epilepsy Center
- Level 4: Epilepsy care provided by neurologists with special training in epilepsy
- Provides the most complex forms of intensive neurodiagnostic monitoring, as well as more extensive medical, neuropsychological, and psychosocial treatments
- Northwestern Memorial Hospital is a Level 4 Epilepsy Center
National Association of Epilepsy Centers treatment guidelines:
- If your seizures have not been brought under control after three months of care by a primary care provider (family physician, pediatrician), further neurologic intervention by a neurologist, or an epilepsy center is appropriate.
- If you are seeing a general neurologist, and your seizures have not been brought under control after 12 months, you should request a referral to a specialized epilepsy center with an epileptologist.