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Treating Epilepsy: Medicines

If you’ve been diagnosed with epilepsy, your healthcare provider will create a treatment plan for you. Medicines called antiepileptic or antiseizure medicines are the main treatment for epilepsy. These medicines greatly reduce or prevent seizures in most people who take them. Other treatment choices may be available for some people. Treating epilepsy can be difficult when medicine is not keeping seizures under control (refractory epilepsy), or when medicines have harsh side effects. It can also be difficult to treat epilepsy in pregnant people. 

Woman taking pills.
Take your medicines exactly as directed by your healthcare provider.

Your medicine plan

Your healthcare provider will work with you to create the best medicine plan for you:

  • Type of medicine. There are many types of AEDs. The first type you try will likely help you. The first antiseizure medicine used can stop seizures in almost half of people who use it. If not, your healthcare provider may suggest another type or a combination of AEDs. If you plan to become pregnant or are already pregnant, your medicines might need to be adjusted by your provider to protect your developing baby. You may also need special vitamins to reduce risk for birth defects.

  • Dosage. You will probably be started at a low dosage, depending on how severe your seizures are. The dosage will be slowly increased until your seizures are better controlled or you reach a target dosage.

  • Rescue medicines. Your treatment plan may include special medicines to stop seizures. They can be given to you during a seizure only by someone who has been specially directed by a healthcare provider.

After you start taking medicines, you may have follow-up testing. These tests measure the level of medicine in your blood. You will eventually need to have these tests from time to time. But certain medicines don’t need lab testing. Your healthcare provider may also need to check certain blood tests to watch for side effects while on AEDs.

When taking epilepsy medicines

DO take your medicines exactly as directed.

DO keep a current list of all medicines you’re taking and show it to your healthcare provider. Make sure you show the list and ask about interactions with any healthcare provider prescribing new medicine for you.

DO know that certain epilepsy medicines can interfere with how birth control pills work.

DO store pills in a cool, dry place (not in the bathroom).

DON’T stop taking your medicines, skip a dose, or change your medicine amount without your healthcare provider’s approval.

DON’T change brands of medicine (usually generic medicines are OK), or even forms of one brand (from tablet to liquid, for instance), without your healthcare provider's approval.

DON’T take herbal supplements or antacids without talking to your healthcare provider first. Ask your pharmacist about taking over-the-counter medicines.

Possible side effects of epilepsy medicines

Epilepsy medicines often have effects that are not intended (side effects). Most of these effects go away after a few weeks. The most common side effects of epilepsy medicines include:

  • Dizziness

  • Trouble concentrating

  • Tiredness

  • Stomach upset

  • Weight gain or loss

  • Depression

  • Allergic reaction, such as a rash or fever

  • Kidney stones

  • Tingling sensations

Other treatments for epilepsy

  • Brain surgery. Brain surgery may sound scary, but it may be a choice if you are still having seizures while on medicine. It can greatly reduce or get rid of seizures, without causing loss of function. It impacts small parts of your brain that cause seizures. It leaves the rest of your brain unharmed. In most cases, only people whose seizures start as partial seizures can have the procedure.

  • Vagus nerve stimulation. A device is placed under the skin in your chest. The device is connected to a nerve in your neck called the vagus nerve. The device sends electrical impulses through your vagus nerve to your brain. The impulses have been shown to help reduce seizures.

  • Brain stimulation. A newer device is now available to stimulate a part of the brain to prevent a seizure from spreading. This is not for all types of seizures and only for adults with epilepsy. 

Online Medical Reviewer: Anne Fetterman RN BSN
Online Medical Reviewer: Joseph Campellone MD
Online Medical Reviewer: Raymond Kent Turley BSN MSN RN
Date Last Reviewed: 8/1/2022
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