Over the last few decades, new drugs for epilepsy have been developed which allow many people; approximately 75% - to live full, active, and virtually seizure-free lives. As there are over 40 different types of epilepsy, accurate identification of the epilepsy experienced by an individual is essential to ensure correct treatment. 

Most anti-epileptic drugs (A.E.D.s) have at least two names, a chemical or generic name and a trade or brand name which has been given by the manufacturer of the drug.  Anti-epileptic drugs come in many forms; tablets, coated pills, capsules, syrups and liquids.  There are first line drugs which are prescribed alone when an anti-epileptic medication is started and second line drugs that are usually prescribed as an addition to existing first line therapy. 

WHAT DO ANTI-EPILEPTIC DRUGS DO? 

• There is at present no known cure for epilepsy but anti-epileptic drugs help to control the condition. Some drugs work by making over-active brain cells less excitable whilst others decrease the brain cells; ability to transmit abnormal impulses to each other. People with newly diagnosed epilepsy should be closely monitored when first prescribed medication. 

• Only one drug should be prescribed at a time and the drug dose altered as appropriate in order to achieve complete control of seizures. 

• Monitoring involves checking the control and frequency of seizures and any side-effects that may be experienced. Measurement of drug levels by blood testing may be appropriate in certain conditions:

• if it is not clear if a patient is taking the prescribed dose of medication   
• if it is not certain whether symptoms may be dose-related side-effects 
• if other drugs that may affects the patient's anti-epileptic drugs are being started or stopped during pregnancy  as a guide to finding the correct dose of Phenytoin as the relationship between dose and serum level is complex 
• If, despite appropriate treatment, complete control of seizures cannot be achieved, drug treatment should be kept as simple as possible in order to minimise side-effects and chronic toxicity. 

• To help control seizures, a roughly constant amount of the appropriate anti-epileptic drug in the bloodstream is necessary.  Prescribed medication should be taken in the exactly the right dose, regularly, and and at approximately the same time every day.  One missed dose on rare occasions is unlikely to cause any harm.  Anti-epileptic medication should NEVER be stopped abruptly without seeking medical advice.  Extra medication should never be taken unless instructed to do so by a medical practitioner. 

• All drugs have potential side-effects as well as benefits. Some people experience no side-effects at all or they may be fairly minor and only occur at the start of treatment, settling down after a short time. Anti-epileptic drugs act on the brain and may cause drowsiness, nausea, sedation, and unsteadiness Side-effects sometimes occur if the dosage of drugs is too high and chronic side-effects may be experienced if drugs, usually the older type,  are taken over a long period of time  - medical advice should always be sought.  The range of drugs available means that a person suffering unacceptable effects with one drug can usually be switched by his medical practitioner to a drug that suits him/her better.  Even so, there may eventually be a choice between having no seizures but some side-effects or having side-effects but no seizures; this is a decision that should be discussed with a doctor. 

• An allergic reaction, such as a skin rash, can occur in a person taking anti-epileptic medication and this should be reported to the doctor for advice without delay.  When buying non-prescription medicines, for example hay fever preparations, cold cures, and antacids, consult the chemist or doctor as these may interact with epilepsy or anti-epilepsy drugs. 

• Any doctors, dentists and other health practitioners who treat a person with epilepsy should be aware of the condition and of the anti-epileptic medication that is being taken.

• In a recent campaign, women with epilepsy have been encouraged to ask their doctor whether their treatment would affect their menstrual cycle, interfere with the Pill, or affect their ability to conceive, as frequently they had not been warned that some anti-epileptic medication reduced the effectiveness of the contraceptive pill.  It is now recommended that anti-epileptic medication should only involve a single drug, rather than combinations of drugs, and changes to treatments should not be made, while drug contraception is being used.

• Women who want to start a family should be free of epileptic seizures wherever possible. Ideally, every woman with epilepsy should consult her doctor for pre-conceptual counselling and women who do not get their questions answered by their doctor, some of whom are not aware of potential problems, should ask for referral to a Neurologist.

• All anti-epileptic drugs may have adverse effects on a developing baby and some studies have hinted that certain drugs can lead to foetal malformations, such as cleft palate and facial deformities and can interfere with the protection offered by folic acid against spin bifida. Most women with epilepsy are able to conceive children and have a normal delivery but pregnant women with epilepsy do need special care.

• In the U.K. people with epilepsy are eligible for free prescriptions for their anti-epileptic medication and also for other prescribed drugs.

Copyright © by EpilepsyInfo All Right Reserved.

Published on: 2007-05-18 (3338 reads)