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How to Know Which Epilepsy Drug Is Right for You

Summary & Participants

Epilepsy drugs are important for controlling seizures. Although highly effective, they can produce various side effects. Learn which treatments are most appropriate for you.

Medically Reviewed On: July 06, 2008

Webcast Transcript

ANNOUNCER: Epilepsy, defined as the condition of chronic, recurrent, unprovoked seizures, affects approximately 3 million people in the United States. Epilepsy can be treated in a number of ways, including surgery and diet, but it’s most commonly controlled through the use of anti-seizure medications.

TRACY GLAUSER, MD: Medications have been used for the treatment of epilepsy for almost 100 years, but they’re really broken into two major groups. The most common medicines that were approved prior to 1993 include carbamazepine (also known as Tegretol), phenobarbital, phenytoin (also known as Dilantin), and valproic acid (also known as Depakote or Depakene).

Since 1993, eight new medicines have approved in the United States for the treatment of epilepsy: felbamate (also known as Felbatol), gabapentin (also known as Neurontin), lamotrigine (also known as Lamictal), levetiracetam (known as Keppra), oxcarbazepine (known as Trileptal), tiagabine (also known as Gabitril), topiramate (known as Topamax), and zonisamide (also known as Zonegran).

ANNOUNCER: Both the newer and older classes of medications seem to have similar efficacy, or ability to stop seizures. Their differences lay in their side effect profiles, with the newer medications tending to have milder side effects.

BLANCA VAZQUEZ, MD: The older antiepileptic drugs tend to have a heavier side effect profile, especially for cognition. The older drugs are associated with long-term use of and development of neuropathy, sedation, cognitive decline and mood changes. The newer antiepileptic drugs are also associated with some of those behavioral changes, but in a much milder level.

ANNOUNCER: And some side effects are related more closely to some drugs than others.

BLANCA VAZQUEZ, MD: The patients need to know what to look for or what side effects are not acceptable. For instance, the older antiepileptic drugs, like barbiturates, have a lot of sedation and mood changes. Dilantin is associated with major cognitive issues as well as bone loss and hormonal changes for female and male patients.

TRACY GLAUSER, MD: Medicines in general, such as Dilantin, can cause sedation, drowsiness, tiredness, wobbliness in walking and unsteadiness. A medicine like Dilantin can have the rare effect of causing a rash. In addition, chronic use of Dilantin can lead to changes in cosmetic features: coarsening of the facial bones, growing hair on the face, swelling of the gums. Tremor is more commonly seen in children taking valproic acid (also known as Depakote or Depakene).

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