The main way of treating epilepsy is with epilepsy medicines. You may hear these referred to as anti-epileptic drugs.
The following information is taken mainly from the British National Formulary (BNF) Number 63 (March 2012). Published by the British Medical Association and the Royal Pharmaceutical Society of Great Britain, it is updated twice a year. For the most up-to-date information, visit the British National Formulary website.
The medicines listed are those usually prescribed for everyday seizure control. Other medicines, such as diazepam or midazolam, are available for emergency use. We have not included emergency medicines on this list.
Under the heading Indications in epilepsy, the main use of each medicine is given. Sometimes a doctor may prescribe medicines for other seizure types than those listed. You can find information about side-effects of individual epilepsy medicines on the Medicine Guides website.
Epilepsy medicines are available in a number of different formulations such as tablets, capsules, chewtabs, sugar-free liquid, syrup, dispersible tablets, crushable tablets and sprinkle capsules.
For further information about epilepsy medicines, side-effects, dosages, please consult:
- your family doctor
- your specialist
- the Medicine Guides website at medicines.org.uk/Guides
- the BNF website at bnf.org
- the British National Formulary (BNF) -available through booksellers and libraries
or
Contact the Epilepsy Helpline: freephone 0808 800 5050; helpline@epilepsy.org.uk; text 0753 741 0044
Word list
| adjunct/adjunctive |
used with other epilepsy medicines |
|
atypical |
not typical or not usual |
|
monotherapy |
used on its own |
|
focal-onset seizures |
seizures that start in one part of the brain |
|
refractory seizures |
seizures that are difficult to control with epilepsy medicines |
|
secondary generalisation |
Focal seizures that spread to the rest of the brain, causing generalised seizures |
Clicking on some of the medicine names in either column one (generic name) or two (some brand names) will take you to the Medicine Guides website. This will give you more information about the medicine and its side-effects.
| Generic name |
Some brand names |
Indications in epilepsy |
Date of UK licence |
|
acetazolamide, acetazolomide modified release |
Diamox, Diamox SR |
Has a specific role in treating epilepsy associated with menstruation. It can also be used with other anti-epileptics for refractory, tonic-clonic, absence and focal seizures. It is occasionally helpful in atypical absence, atonic and tonic seizures. |
1988 |
|
Focal and secondary generalised tonic-clonic seizures, primary generalised tonic-clonic seizures. |
1965 | ||
|
Adjunct in epilepsy. |
1979 | ||
|
All forms of epilepsy. |
1979 | ||
|
Adjunctive treatment in adults with focal seizures, with or without secondary generalisation. |
2009 | ||
|
Typical absence seizures; it may also be used in atypical absence seizures. Rarely used for myoclonic or tonic seizures. |
1955 | ||
|
Monotherapy and adjunctive treatment of focal seizures with or without secondary generalisation. |
1993 | ||
|
Adjunctive treatment of focal seizures with or without secondary generalisation. (NHS Scotland: accepted for restricted use as adjunctive treatment for focal seizures with or without secondary generalisation in patients from 16 years. Restricted for specialist use in refractory epilepsy.) |
2008 | ||
|
Monotherapy and adjunctive treatment of focal seizures and generalised seizures including tonic-clonic seizures; seizures associated with Lennox-Gastaut syndrome; monotherapy of typical absence seizures in children. |
1991 | ||
|
Monotherapy and adjunctive treatment of focal seizures with or without secondary generalisation and for adjunctive therapy of myoclonic seizures in patients with juvenile myoclonic epilepsy and primary generalised tonic-clonic seizures. |
2000 | ||
|
Monotherapy or adjunctive treatment of focal seizures with or without secondary generalised tonic-clonic seizures. |
2000 | ||
|
phenobarbital (phenobarbitone) |
N/A |
All forms of epilepsy except typical absence seizures |
1912 |
|
All forms of epilepsy except absence seizures. |
1938 | ||
|
Adjunctive therapy for focal seizures with or without secondary generalisation. |
2004 | ||
|
All forms of epilepsy except typical absence seizures. |
1952 | ||
|
Adjunctive treatment of seizures in Lennox-Gastaut syndrome (NHS Scotland: restricted use as adjunctive treatment of seizures associated with Lennox-Gastaut syndrome in patients four years old and above. Also restricted for use when traditional anti-epileptic medicines are unsatisfactory.) |
2007 | ||
|
Epilim, |
All forms of epilepsy. |
1973 | |
|
Adjunctive treatment for focal seizures with or without secondary generalisation not satisfactorily controlled with other anti-epileptics. |
1998 | ||
|
Monotherapy and adjunctive treatment of generalised tonic-clonic seizures or focal seizures with or without secondary generalisation; adjunctive treatment of seizures associated with Lennox-Gastaut syndrome. |
1995 | ||
|
valproic acid |
Convulex |
All forms of epilepsy. |
1993 |
|
Adjunctive treatment for focal seizures with or without secondary generalisation. Not to be prescribed unless all other appropriate medicine combinations are ineffective or have not been tolerated. Should be initiated and supervised by appropriate specialist. Monotherapy for management of infantile spasms in West’s syndrome. |
1973 | ||
|
Adjunctive treatment for refractory focal seizures with or without secondary generalisation. |
2005 |
This information has been produced under the terms of The Information Standard.
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Updated March 2012To be reviewed September 2012
Comments: read the 15 comments or add yours
Comments
Hi i have been diagnosed with epilepsy since 2008.
my first seizure was on 23rd September '08, this also turned out to be the day i fell pregnant with my son, however i did not know this at the time, due to finding out i was pregnant after i had an mri i wasn't put on any medication until after my son was born in june 2009, however i did only have one other seizure during my pregnany, exactly one week before he was born by c-section, as they thought it was too much of a risk for me to give birth naturally.
I have been taking Keppra since june 09 and if anything my seizures have become more regular, i didnt have any the rest of 2009 but this year i have had 5 in total 2 in the past 2 weeks. I have go to my doctor everytime i have a fit and all that the specialist seems to say in response to my GP is just to up my Keppra dose higher, even when i asked if there was not anything else I could try they just told me that it was trial and error and they are going to keep just putting my dose higher, i am on 1000mg 2 times a day and they have just given me a 250 dose to top that up with aswell.
I am desperate to try and get the result i want as I live alone with my son and am terrified i will have one when he is awake and wondering around the house or i'm having a bath etc.
I don't know how i am supposed to explain myself to get the results i want, i.e try another type of medication???
Hi HannahRebecca
I’m sorry you’re having such a hard time at the moment. It can be confusing when doctors steadily increase your anti-epileptic drugs, without trying anything else. The reason they do this is because it’s really difficult to know how much of a drug an individual person needs to control their seizures. That’s why they start the drug at a low dose, and gradually increase it until either your seizures stop, or you start to have side-effects.
The maximum dose of Keppra is 1500 mg twice each day. (British National Formulary, 59, March 2010) As you were on less than that, your doctor increased the dose, before trying anything else. Although this is frustrating, it really is the best way of finding the right dose for you. You can read more about this on the treatment section of our website. If you still have seizures at the highest dose, or get side-effects, your doctor is more likely to consider trying another drug.
If things don’t improve, it would be worth asking your GP to refer you to an epilepsy specialist nurse or consultant. If you don’t know whether there is a nurse in your area, please get back to us, and we’ll do our best to see if there is.
It must be worrying looking after a small child when you are still having seizures. There’s some information about caring for children on our website too.
If you would like to speak with someone about any of your concerns, one of our advisers will be happy to help you. You can either phone the helpline, freephone 0808 800 5050, or email any questions to helpline@eplepsy.org.uk
Kathy
Epilepsy Helpline Team
Hello, I need an immediate advise. My father had an stroke where his body and face stiffen for a minute and foam/cough was coming out from his mouth. He was unconcious for a while after that and feeling very week when gained conciousness and was like his mind was disoriented and he was talking irrelvant things but soon after a day he was fine but still a bit disoriented and very very week.
Doctor had put him on Phenytoin and I am sure he will do his best. but I am just confuse if the stroke he got was a epilepsy attack or could it be a stroke because of the blood clot in brain. Also if this medicine for Epilepsy or anything else?
what is the difference between epilepsy and stroke because of blood clots i.e Ischaemic stroke?
Thank you.
R
Hi Riya
The medication, phenytoin, is an anti-epileptic drug (AED). But recently, it has also been prescribed for neuropathic pain.
If you ask your father’s doctor, they should be able to confirm if it was an epileptic seizure he had. Your description of events suggest it could be a type of epileptic seizure. Here is a link that explains how epilepsy is diagnosed and the tests involved.
You may wish to also contact the Stroke Association regarding your father. They will be able to tell you more about strokes and how a stroke is diagnosed and treated.
Diane
Epilepsy Helpline Team
Hi,
My main drug is Epilim but my Doc believes that this is no longer working. I have read horrible reports on the side effects of Kepra. While 30% say it has helped, the remaining 70% odd stated that it has ruined lives… Is it a good drug?
Thanks
Alan
Hello, My name is sue and i am new to this site.
My son has epilepsy he is 16yrs old he has been having seizures since earlier this year possibly before then. It has been very hard for him to come to terms with this and he had only recently started having medication Sodium Valporate. He doesn't seem to be having any real problems at the moment but he had two seizures on Sunday within 3 hours of each other which was so frightening. My question is since then he has had blurred vision on and off since Sunday, is the due to his medication or due to the fact that he had two seizures in such a close space of time? This is something that my son and myself are just starting to get our heads around, so please any help or information would be much appreciated.
Sue
Hi Sue
Sometimes vision disturbances, especially if they come and go, can be related to anti-epileptic drugs (AEDs). This is more likely to be the case if the changes in vision regularly happen a certain amount of time after the AEDs have been taken. It would certainly be worth asking a pharmacist, or your son's doctor about.
It must be very difficult for your son to have to think about his epilepsy when he has so many teenage things to do. He might find the teenage section of our website interesting. We also have a booklet called Upfront, that was written especially for teenagers. As he's 16, he might also like to speak to other young people on our online forum.
If you or your son would like to speak with one of our epilepsy advisers, please call the freephone Epilepsy Helpline, or email them at helpline@epilepsy.org.uk.
Kathy
Epilepsy Action
I am not epiliptic, but I take AEDs for a condition similar to Trigeminal Neuralgia ["face pains"].
Carbamazapine caused my body to shut down, I became very dizzy and disoriented and was almost fainting as I dialled 9-11. I had been dry heaving for a couple hours too.
Now I am trying Gabapentin, but I am stumbling and staggering a bit now too, and feeling weak and tired and confused too. I need something that helps these face pains stay away, but maybe I am just not going to do well on any AEDs? Will they all cause me to "feel drunk"? Or worse?
They are about all the doctors offer for Trigeminal Neuralgia, at least that I have been told about.
Karlin, just reading the comments folk have submitted about the drugs as I am epileptic.
I noticed your comments about the drugs you have taken for Trigeminal Neuralgia. My Mother suffers with a severe form of the condition and was on Gabapentin. She was on the max permisible dose and was finding it was giving her the same side effects with little control of the condition.
She is now on Lamotragine which is controling here condition without the side effects mentioned. Have to say she is starting to get back to a normal life.
Hope this helps but she does attend a focus group who suffer with Tri that is based in Southampton.
Ian
I highly recommend Lamotrigne and Keppra combo. They seem very effective and I seem to have no epilepsy "traits" appearing at all. This combo seems to be completely uneffected by alcohol and be pretty understanding re: being taken a little irregular. I am quite busy and therefore have overdosed a couple of times, the effects haven't been too bad: both led to me crawling to bed and passing out for a while. The first also had a weird effect on speech despite me being frustrating aware of it (more admusing then anything else) I was trying to ask my wife for a couple of tea and kept saying "a glass of tomato", when I tried to explain what had happened I ended up waving my pill packets at her saying "too many articles"???
Negatives are:
I have found with Keppra that when you first take it really takes it out of you (drowiness similar to overdosing)
When warning says it makes you "aggresive" it haven't found it quite like that but more it something really winds you up then your adrenaline gland seems to open like a tap, not so much aggression as mildly disabling.
I am 16 years old, my first episode occurred when I was about 6-7 years old, when I had met with an accident. At that time no one took it seriously enough. But around the time I was eleven I faced some frequent episodes. The episode was preceded by fever or exposure to blood. Following which, I consulted a Child neurologist, and she she put me on Sodium Valporate ER 250 mg along with Frisium and Rejunuron OD. I have been under the same medication for the last five years( Frisium Excluded), and the dosage of Sodium Valporate varied as: 250 mg(Twice a day), 500 mg(twice a day), 750 mg(once a day), and 500 mg(once a day), which I am currently on. During this period I have had 3 episodes. What I want to know is that, why do I face sudden head rush? And how much longer will I be under medication?
Yours Sincerely,
Vinayak Gupta
My son is 21 and has suffered from epilepsy since he was about 1yr old, due to a benign brain tumour, then removed. He's always had poorly controlled epilepsy and the various drugs tried in infancy and teenager years caused him extreme behavioural problems. He has been on Epilim chrono since age 8 500mg b.d. Since about two years ago, a new neurologist prescribed him Lamotrigine in addition to Epilim, stating that as his metabolism was changing due to growing, it was likely that the behavioural problems in terms of side effects would not manifest themselves. However, I noticed that at each increase of 25mg of lamotrigine, his behaviour was different and challenging, so I asked to titrate lamotrigine for longer periods, so much so that he is still titrating it and is now taking 50mg am and 75mg pm in addition to the Epilim. However, since September, at each increase he has complained of having vivid dreams, really frightening at times. Once he had a sort of visual hallucination for about 20 minutes, where he saw everything as if the colours were fading into each other and stated that he could not focus on things. He then started shaking his leg and swinging from right to left for about 10 min. On another occasion he had gustative hallucinations and became high (giggling and fixated on doing certain things). Two nights ago he suddenly said he felt his brain shaking and then his voice changed as if he was contracting his abdominal muscles a lot. He then complained of abdominal and chest pain. He felt as if in another world throughout the night and 'dizzy' till midday the next day.
I have read that Valproic acid (an ingredient of Epilim) causes the half life of lamotrigine to increase three fold and I am trying to find more info on this. Does anyone know how these two drugs work together? If the half life of lamotrigine increases by three times, what is the danger when administering it on a daily basis? Shouldn't that be changed?
I am not sure the neurologist will actually listen to me as the last time he said that my son had anxiety when I explained about the visual hallucinations. I know for a fact that it was not anxiety and my son also confirmed this.
Thanks in advance
Su
Hi Su
I’m really sorry to hear that you son is having so many problems at the moment. Although we’re not medically qualified, we do know that Epilim and Lamotrigine can interact, which is why there are specific instructions in the British National Formulary (BNF) about how Lamotrigine should be added to Epilim. This is information from BNF61:
Lamotrigine
Adjunctive therapy of seizures with valproate, Adult: initially 25mgs on alternate days for 14 days then 25 mgs once daily for further 14 days, thereafter increased by maximum 50 mgs every 7-14 days, usual maintenance 100-200 mgs in 1 – 2 divided doses.
These two drugs are often used together successfully, but some people may be sensitive to the combination.
The vivid dreams and hallucinations need checking out. They could be related to temporal lobe epilepsy, or possibly to his drugs. If his current doctor isn’t an epilepsy specialist, it could be useful to ask for a second opinion from an epilepsy specialist. If you tell us where you live (by emailing helpline@epilepsy.org.uk or calling the Epilepsy Helpline freephone 0808 800 5050) we will do our best to tell you where your local epilepsy specialist is.
Kathy
Advice and Information Team
Hi at the beginning of the week I had a seizure that resulted in me stop breathing and and have to be ventilated in intensive care for two days and since coming around I've had a persistent head ache and not taking the news of being dis agonised with epilepsy well.. They have put me on clobazam and levetiracetam does anyone have any idea how these medications will affect me or give off any side effects??
Hi
It must have been frightening for you to realise you have been in intensive care. This sort of thing doesn’t commonly happen to people with epilepsy, but having a headache after a seizure is common.
You asked about the epilepsy medicines you’ve been prescribed and their side-effects. Everyone will react differently to the medicines they’ve been given. However, you can get some details about the possible side-effects of medicines on the patient information leaflet (PIL). The PIL should, by law, be given with each prescription received from the chemist. If you don’t have one, you could go back and ask the chemist for one.
There is also a website called medicines.org.uk. You can search their website by your medicine name. Then follow the instructions that relates to your epilepsy medicines and scroll down to information on possible side-effects.
If you have any questions about your diagnosis that you couldn’t find on our website, you could talk to one of our trained advisers on our Epilepsy Helpline, 0808 800 5050.
Advice and Information Team