Treatments available include medication, non-drug control, and surgery.
Medication Treatment Options
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. The doctor will choose the best medication 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.
Some of the medications commonly used to treat epileptic seizures include:
- Carbamazepine (Tegretol)
- Gabapentin (Neurontin)
- Levetiracetam (Keppra)
- Phenytoin (Dilantin)
- Pregabalin (Lyrica)
- Topiramate (Topamax)
- Valproic acid or divalproex sodium (Depakene, Depakote)
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.
Epilepsy is considered to be controlled when the person is seizure-free. Even having a few seizures a year can significantly impact quality of life—the person cannot drive and employment options, social contacts and emotional health may be affected. People with epilepsy are at risk for sudden unexplained death in epilepsy (SUDEP). Risk factors for SUDEP include poor seizure control, poor adherence with anti-epileptic medications, use of more than one anti-epileptic medication, frequent changes of dose or type of anti-epileptic medication, severe epilepsy, male gender, alcohol abuse, and certain epilepsy syndromes. Therefore, becoming seizure-free is imperative.
- 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 that may increase seizures or interfere with anti-epileptic medications, such as menstruation, fertility, contraception, pregnancy and menopause.