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What to know about seizure medications

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Medication typesFocal seizure medicationsGeneralized seizure medicationsTopiramateSummary
There are different seizure medications for different types of seizures. You can work with a doctor to ensure you’re using the right one.
Medically reviewed by Ami Patel PharmD, BCPS
Written by D. M. Pollock
Updated on March 22, 2023

Seizures can happen for many reasons, including epilepsy disorders, head injuries, infections, or stress.

The Centers for Disease Control and Prevention (CDC) defines active epilepsy as adults who take medication to control seizures or have had one or more seizures in the past year.

About 1 in 10 people may experience a seizure during their lifetime.

Types of medications

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Seizures are the result of disruption between the nerve cells in your brain. Different types of disruption can cause different types of seizures.

Typically, sodium channels control these disruptions. Sodium channels are molecules that initiate activity in the brain cells — or neurons.

There are lots of different antiepileptic drugs (AEDs). Some of them are broad spectrum, meaning they help manage different types of seizures, whereas others are more specific — for example, useful for treating focal seizures only. These are narrow-spectrum medications.

There are numerous ways in which AEDs work. They either block repetitive stimulation and activation of certain molecules in your brain or slow the activation of those molecules.

The type of AED your doctor will recommend depends on the type of seizures you experience.

It is important to note that the medications outlined below can help prevent seizures in people who are susceptible to them. They will not resolve an active seizure, as can happen with status epilepticus.

Status epilepticus is when seizures last 5 minutes or longer or a person has repeated seizures without recovering between them. A doctor may prescribe benzodiazepines as an emergency drug to break an ongoing seizure.

Focal seizure medications

Partial seizures, also known as focal seizures, affect one isolated region of your brain. With focal seizures, you may experience one of two types, but distinguishing them can be challenging:

  • Focal impaired awareness: You may lose consciousness during one of these seizures and have no recollection of the event.
  • Focal onset impaired awareness: You remain conscious throughout the seizure, and you may remember some details of the event. They can feel like a panic attack.

Below, we look at some of the medications offered to treat focal — or partial — seizures.

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Carbamazepine

Carbamazepine (Tegretol, Carbatrol) is available under the names Epitol and Equetro.

It is also useful for the treatment of schizophrenia. It works by helping to reduce the amount of activity between neurons, which can be the cause of seizures.

Common side effects can include:

  • drowsiness
  • nausea
  • vomiting
  • dizziness
  • impaired vision
  • unsteady walking

Lacosamide

Lacosamide (Vimpat) is available in tablet form, as an injection, or as a liquid solution, which can be more practical for children. It is useful for treating both aware and impaired awareness focal seizures, as well as general tonic-clonic seizures.

The most common side effects include:

  • headache
  • sleepiness
  • coordination problems
  • dizziness
  • nausea
  • vomiting

Phenytoin

Phenytoin (Dilantin and Phenytek) is one of the oldest treatments for seizure, approved by the Food and Drug Administration (FDA) in 1939. It is available as oral tablets, chewable tablets, and a liquid solution.

Some common side effects include:

  • memory problems
  • brain fog
  • slurred speech
  • jerky eye movements

Oxcarbazepine

Oxcarbazepine (Trileptal, Oxtellar XR) is an anticonvulsant drug, suitable for children from the age of 4 years. It is available as an extended-release tablet. It blocks the sodium channels in the brain to prevent neuron misfiring, which can cause seizures.

Common side effects include:

  • double vision
  • nausea
  • tiredness
  • trembling hands
  • vomiting
  • dizziness
  • low sodium levels in the blood

A doctor may monitor your sodium levels if they prescribe you this drug.

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Pregabalin

Pregabalin (Lyrica) comes as an oral tablet and a liquid. It can be a component of combination therapy to treat focal seizures. Some common side effects can include:

  • dry mouth
  • weight gain
  • swelling of your hands and feet
  • dizziness
  • sleepiness

Generalized seizure medications

Generalized seizures affect both sides of your brain and affect your whole body.

  • Tonic-clonic seizures: Or grand mal seizures can cause muscle jerks and loss of consciousness.
  • Atonic seizures: In these seizures, the muscles in the body relax completely, which can led to falls.
  • Absence seizures: Also known as petit mal seizures, these cause rapid blinking and look as though you are daydreaming.

General or broad-spectrum medications are useful, particularly if the type of seizures you experience is uncertain. Some of these include:

Valproic acid

Valproic acid (Depakene). In the United States, this medication is available as tablets and oral syrup. If you experience hepatic (liver) problems, you should avoid this type of seizure medication.

Some common side effects include:

  • abdominal pains
  • tremors
  • alopecia
  • insomnia
  • mood changes, such as an increase in nervousness
  • dizziness

Levetiracetam

Levetiracetam (Keppra and Spritam). This medication is available as an oral tablet and a liquid solution, as well as an injection. It is also available as a slow-release drug, Keppra XR. Doctors do not know precisely how this drug works. There are no known long-term effects, but some common side effects include:

  • sleepiness
  • mood changes
  • behavior changes
  • irritability
  • loss of strength
  • headaches

Lamotrigine

Lamotrigine (Lamictal). This medication can help treat tonic-clonic seizures and Lennox-Gastaut syndrome. It is available in immediate-release and extended-release forms. If you could be pregnant, it is important to speak with your doctor before taking lamotrigine.

Common side effects can include:

  • chest pain
  • weight changes
  • weakness
  • anxiety
  • headaches
  • constipation
  • nausea

Clobazam

Clobazam (Onfi and Sympazan). This medication belongs to a group of drugs called benzodiazepines but provides a more effective treatment than other medications in this group while reducing side effects. It is effective for treating children with Lennox-Gastaut syndrome.

Some side effects include:

  • nausea
  • blurry vision
  • dry mouth
  • constipation
  • low moods

Clonazepam

Clonazepam (Klonopin). This is another medication in the group of benzodiazepines. It works by reducing the excitatory ability of the cells in the brain, which reduces the likelihood of a seizure. They are available as tablets or dissolving wafers.

Common side effects include:

  • impaired memory
  • depressive episodes in adults
  • hyperactivity in children
  • unsteadiness
  • dizziness
  • loss of appetite

Topiramate

Topiramate (Topamax and Qudexy XR). This medication is available in extended-release form. It can treat tonic-clonic seizures, but also focal seizures and Lennox-Gastaut syndrome. This drug prevents your brain cells from working at the speed that occurs in a seizure.

Some common side effects include:

  • confusion
  • difficulty retrieving words
  • nervousness
  • loss of appetite
  • fatigue

Your doctor will work with you to help create the most effective combination of medications to manage your symptoms. If any side effects do not go with time, speak with your doctor, as there may be other options better suited to your lifestyle.

Summary

A range of factors can lead to a seizure, including head trauma, infections, and genetics. Epilepsy is a condition where people have seizures regularly. Typically, there are two main types of seizures: focal seizures and generalized seizures.

Usually, a combination of medications can help manage seizures. Anticonvulsive medications and benzodiazepines are the two main medication types your doctor may recommend.

A doctor may use benzodiazepines in an emergency to break an ongoing seizure.

If you experience any negative side effects that do not go with time, speak with your doctor. They can work with you to determine the best treatment path for you.

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