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A list of epilepsy drugs: 9 options

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LamotrigineValproic acidAcetazolamide ERCarbamazepineEthosuximideOxcarbazepineZonisamideFelbamateTiagabineSummary
Finding the right epilepsy drug is often a process of trial and error. We take a closer look at the available options.
Medically reviewed by Alexandra Perez, PharmD, MBA, BCGP
Written by Rashida Ruwa, RN
Updated on March 23, 2023

Epilepsy is a neurological condition characterized by seizures, which can range in severity from mild to life threatening. Despite the availability of several treatment options, there is no known cure for epilepsy.

The most common treatments for epilepsy include epilepsy drugs, surgery, and dietary therapy. While these treatments can effectively manage epilepsy, they can also have side effects and may not work for everyone. 

These medications are listed in no particular order.

1. Lamotrigine (Lamictal)

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Lamotrigine works by blocking sodium channels. This makes neuron activity less excitable, which can prevent the spread of epileptic activity.

This drug is common for treating various types of epilepsy, including partial and generalized tonic-clonic seizures.

It has fewer cognitive side effects than other drugs, like drowsiness, and you can use it safely for long periods.

 Potential side effects of lamotrigine to consider include:

  • irritability
  • insomnia
  • headache
  • nausea and vomiting
  • dizziness

Lamotrigine can also stabilize mood in people with bipolar disorder.

2. Valproic acid

Valproic acid is used to treat various types of seizures, including absence seizures and generalized tonic-clonic seizures. It works by increasing gamma-aminobutyric acid (GABA) levels in the brain, which helps reduce the activity of certain neurons and prevent seizures. 

The benefits of valproic acid include fewer cognitive side effects than other drugs and the prevention of migraine in some people.

Potential risks or side effects of valproic acid include:

  • headache
  • abdominal pain
  • nausea and vomiting
  • liver damage, particularly in young children and people with liver disease
  • pancreatitis
  • developmental side effects in babies, like neural tube defects, when taken during pregnancy

Valproic acid can also stabilize mood in people with bipolar disorder.

If you take prescription medication for epilepsy, the Optum Perks free Discount Card may help you get up to 80% off your usual costs.

3. Acetazolamide ER

Acetazolamide ER (extended release) is a common add-on treatment for epilepsy. It works by inhibiting an enzyme in the brain that controls the acid-base balance, which can help reduce the frequency of seizures.

Benefits of acetazolamide ER include:

  • treating glaucoma as it helps reduce pressure in the eye
  • reducing symptoms of altitude sickness

Potential side effects of acetazolamide ER to consider include:

  • nausea and vomiting
  • electrolyte imbalances
  • diarrhea
  • drowsiness
  • allergic reaction

4. Carbamazepine (Tegretol, Carbatrol)

Carbatrol and Tegretol are brand names for carbamazepine, which treats various types of seizures, including partial and generalized tonic-clonic seizures.

This drug blocks sodium channels in nerve cells, making it harder for the cells to become excited and generate electrical signals. 

These branded drugs also help treat bipolar disorder and relieve facial pain associated with trigeminal neuralgia.

Potential side effects to consider:

  • dizziness and drowsiness
  • nausea and vomiting

In rare cases, carbamazepine can cause more serious side effects, such as:

  • severe skin reactions, such as Stevens-Johnson syndrome or toxic epidermal necrolysis
  • blood disorders, like aplastic anemia
  • low sodium levels in the blood (hyponatremia)
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5. Ethosuximide (Zarontin)

Ethosuximide is commonly used to treat absence seizures, which are a type of epileptic seizure that can cause brief lapses of consciousness.

This drug is thought to work by blocking calcium channels in the brain, reducing neuron excitability and helping prevent seizures.

Benefits of ethosuximide include:

  • minimal side effects
  • fewer drug interactions
  • can be used for the long term

Side effects of ethosuximide can include:

  • dizziness 
  • nausea or vomiting
  • loss of appetite
  • hiccups
  • insomnia

6. Oxcarbazepine (Trileptal)

Oxcarbazepine is primarily used to treat partial seizures. It works by blocking sodium channels in the brain, which reduces the ability of neurons to fire rapidly and helps to prevent seizures.

The benefits of oxcarbazepine include reduced risk of drug reactions. It is usually well tolerated with few side effects.

Side effects and risks of oxcarbazepine can include:

  • dizziness
  • headache
  • nausea or vomiting
  • hyponatremia
  • increased suicidal ideation

7. Zonisamide (Zonegran) 

Zonisamide is believed to work by blocking sodium channels in the brain, which reduces neuron excitability and helps prevent seizures.

Side effects of zonisamide can include:

  • drowsiness
  • nausea or vomiting
  • loss of appetite
  • weight loss
  • confusion

8. Felbamate (Felbatol)

How felbamate works is not fully understood, but it is thought to modulate several neurotransmitter systems in the brain, including:

  • blocking NMDA glutamate receptors, which reduces the excitability of neurons and helps to prevent seizures
  • enhancing the activity of GABA, a brain chemical (neurotransmitter) that inhibits neuronal activity and helps to prevent seizures

Side effects of felbamate can include:

  • drowsiness
  • headache
  • nausea
  • loss of appetite
  • insomnia

9. Tiagabine (Gabitril)

Tiagabine is primarily used to treat partial seizures. It works by blocking GABA transporter uptake of the neurotransmitter GABA.

This increases the concentration of GABA in the neuron, which reduces neuronal activity and decreases the frequency of seizures.

The side effects of tiagabine may include:

  • dizziness and drowsiness 
  • headache 
  • tremors 
  • nervousness 
  • confusion 
  • muscle weakness 

Summary 

There are a wide variety of medications available for the treatment of epilepsy, each with unique benefits and risks.

While some medications may work better for certain people than others, it is important for you to work closely with a doctor to determine the best course of treatment for your needs.

If you need help covering the cost of medications, the Optum Perks free Discount Card could help you get up to 80% off prescription medication. See how much you can save on your medication here.

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