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 64 (September 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 focal seizures with or without secondary generalisation. |
2011 | ||
|
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 |
We can provide references and information on the source material we use to write our epilepsy advice and information pages. Please contact our Epilepsy Helpline by email at helpline@epilepsy.org.uk.
This information has been produced under the terms of The Information Standard.
-
Updated September 2012To be reviewed March 2013
Comments: read the 4 comments or add yours
Comments
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