A B C D E F G H I J K L M N O P R S T U V W

EPILEPSY DRUGS

What are the types of Epilepsy Drug ?

These are a group of very different drugs which have been found to stop or help reduce fits: phenytoin (Epanutin), sodium valproate (Epilim), carbamazepine (Tegretol), ethosuximide (Zarontin, Emeside), phenobarbitone, primidone (Mysoline), vigabatrin (Sabril), clonazepam (Rivotril), gabapentin (Neurontin), lamotrigine (Lamictal), paraldehyde, diazepam (Stesolid, Valium, Diazemuls, Valclair), chlormethiazole (Heminevrin, clobazepam (Frisium), tiagabine (Gabitril), piracetam (Nootropil), fosphenytoin (Pro-epanutin), methylphenobarbitone (Prominal), topiramate (Topomax), oxcarbazine (Trileptal), and valproic acid (Convulex)).

What are Epilepsy Drugs for ?

Some are used regularly to prevent fits. Others are used in single doses to stop a fit if it is lasting a long time (status epilepticus). An epileptic fit happens when the electrical signals between the nerve cells in the brain suddenly get out of control. Too many messages are sent around the brain and to the muscles in the rest of the body. Loss of consciousness, a fit or both then occur. Different types of epilepsy require different drugs. For generalized seizures (sometimes called grand mal fits) , phenytoin, phenobarbitone, carbamazepine, sodium valproate, lamotrigine and primidone are the drugs most commonly used. Absence seizures (including petit mal) are usually treated with ethosuximide and sodium valproate. Myoclonic seizures or jerks are often treated with sodium valproate, clonazepam, ethosuximide or phenobarbitone. Other seizure types such as partial, atypical absence, atonic and tonic seizures are treated with a wide variety of the above medicines.

How do Epilepsy Drugs work ?

Most anticonvulsants work by stopping the nerve cells from sending so many messages to each other. This prevents or treats the fit.

How should Epilepsy Drugs be used ?

Your doctor will often give you a low dose at first. The dose is then gradually built up slowly to stop you having fits and to limit side-effects. Everyone's dose tends to be different. Your doctor may need the help of a blood test to get the right level of drug in your blood. We know what this level should be for many of the common drugs. This test may need to be repeated from time to time to check that the level is still right. Although single drug treatment is preferred, a combination of drugs may be used. This allows a lower dose of each, often helping to avoid side-effects. Depending on the cause of the fits, some may need to be taken for several years, and even life long. The drugs used to stop a prolonged fit are given by injection or by enema into your rectum (back passage). They act quicker this way. You cannot swallow safely while you are having a fit. Most drugs are given in hospital by trained staff. You may be given diazepam liquid in tubes to be given into your rectum (back passage) by a carer. This is useful first aid for a prolonged fit.

During Treatment with Epilepsy Drugs

Your fits will become less frequent, and should stop completely. If you didn't have fits very often, it may take some time before you can be sure that the anticonvulsant is helping. Side-effects can start straight away. It may therefore be tempting to stop taking your drug too soon. Having told your doctor about any side-effects, he may suggest that you are patient. Some mild side-effects do wear off after a few weeks. Anticonvulsants can cause poor memory and concentration, poor balance, slurred speech, blurred vision, drowsiness, vague feelings, dizziness, stomach upsets and lethargy. These general side-effects occur because the drugs currently used can affect even normal brain functions. This happens with doses which are hardly more than what is needed to control the fits. If they happen, you are probably having too much of the drug. See your doctor promptly. In addition, each drug may have its own side-effects which you should watch for. Some drugs can cause serious blood (carbamazepine, ethosuximide, sodium valproate, phenytoin, fosphenytoin, valproic acid), liver (carbamazepine, sodium valproate, valproic acid) and skin (carbamazepine, lamotrigine, phenytoin and fosphenytoin) problems. Your doctor can tell you what to look out for in your case, and how quickly to report the signs. Valproate or valproic acid can also cause irregular periods. Vigabatrin can cause serious vision problems, so any changes in your eyesight should be reported to your doctor as soon as possible. Phenytoin is commonly used and can cause insomnia, swelling of gums and increased body hair. This is not a full list. Read any package leaflets given with your medicines, and discuss any possible side effects with your doctor or pharmacist.

Drug Interference

Alcohol and any sedative drug can increase the « general side-effects » mentioned above. Many anticonvulsants can affect the way that other drugs are cleared from the body. They may either slow down or speed up the process. You may find therefore, that if more than one anti-convulsant is used together, doses may need to be changed. This also happens with other drugs (particularly warfarin, a blood thinner) and theophylline (for asthma). Gabapentin rarely interferes with other anticonvulsants. Lamotrigine and vigabatrin rarely interfere with other drugs apart from other anticonvulsants. Some anticonvulsants can reduce the effectiveness of the contraceptive pill. This is not a full list of interactions. It is important that any new doctor or pharmacist you see knows full details of your medication.

What if Epilepsy Drugs are not taken ?

Do not stop or reduce your dose without doctor’s advice. Your fits could quickly return. When the time comes to stop, your doctor will advise you how to reduce the dose gradually. If you forget to take a dose at the usual time, take it as soon as you remember. If your next dose is due soon, get further advice either from any package leaflet or from your doctor or pharmacist. The advice for each anticonvulsant may be different.

General advice on Epilepsy Drugs

You should not drive unless your doctor says it is safe. The DVLA will normally want you to have been free of fits for one year before they will allow you to drive again. You should tell your doctor if you could be pregnant, or if you want to become pregnant or to breast feed. You will need specialist care during pregnancy, to make sure that neither you nor your baby comes to harm. If you have any question which is not answered by this leaflet, ask your pharmacist or doctor. Keep the leaflet handy in case you wish to refer to it later.