If you have just been diagnosed with epilepsy, you may have questions about medication and treatment.
AEDs work by controlling the electrical activity in the brain that causes seizures. They do not cure epilepsy and are not used to stop seizures while they are happening. AEDs work best if they are taken regularly, around the same time each day. Up to 70% of people (7 in 10) could have their seizures fully controlled (stop having seizures) with the right AEDs.
The aim of treatment is to stop all of your seizures with the lowest dose of the fewest number of AEDs and with the least side effects. Usually treatment starts using a single AED at a low dose, which is increased slowly (called titration), until your seizures are controlled. If your seizures are not controlled with this drug, a different AED is usually tried (by adding in the new drug and then slowly withdrawing the first one). If your seizures are not controlled with a single drug, another drug might be added, so that you take two different AEDs each day.
Medication for epilepsy
There are lots of different AEDs and your neurologist will usually choose the AED that is most suitable for the type of seizure you have and your particular situation. Finding the right drug at the right dose can sometimes take time.
Most AEDs have two names, a generic name and a brand name given by the manufacturer (for example, Nurofen is a brand name of the generic painkiller ibuprofen). Some AEDs have more than one generic version and each version can be given its own name. For some AEDs, different versions of the drug can vary slightly and this could affect seizure control. Once you and your doctors have found an AED which helps to control your seizures, and which suits you, it is recommended that you take the same version of AED consistently with every prescription, whether it is a generic or brand version. This is called ‘consistency of supply’.
If a prescription only has the generic name of the drug, the pharmacist can give any version of the drug with that name. However, if the prescription has the brand name of the drug, the pharmacist has to give that brand. It can be helpful to get your prescription from the same pharmacist each time as some pharmacists keep records of the medication they dispense and can help with questions about prescriptions. There are also lots of other ways in which your pharmacist can help you.
The ketogenic diet is one treatment option for children with epilepsy whose seizures are not controlled with AEDs. The diet may help to reduce the number or severity of seizures and can often have positive effects on behaviour.
Deep brain stimulation
Deep brain stimulation therapy is a surgical treatment which aims to reduce seizures not controlled with medication, and where surgery to treat the cause of seizures is not possible. It involves implanting electrodes into specific areas of the brain.