15.1.6  Drug treatment of epilepsy

Although there is no cure for epilepsy, it is treatable and can be controlled with regular medication. Epilepsy is a long-term condition and, with treatment, the outlook is very good for most people. Symptoms can usually be controlled using a class of medication known as antiepileptic drugs (AED).

It can take some time to find the right type of AED, and the correct dose, before the seizures are brought under control. With a clear understanding of epilepsy and effective management in the community, the risk of seizures can be minimised. A general guide about the use of antiepileptic drugs is given below.

AEDs do not cure epilepsy, but they do prevent seizures from occurring. There are many different AEDs, but they all tend to work by either altering the electric transmissions in the brain or altering the chemicals in the brain. Adverse effects of medication (see also Section 11.2.4 of Study Session 11) are common when people begin taking AEDs and may include nausea, abdominal pains, drowsiness, dizziness, irritability, and mood changes. For some people, the side effects will pass within a few days, whereas for others, the effects may persist for many months. Some side effects, which produce symptoms that are similar to being drunk, occur when the dose of AEDs taken is too high. They include unsteadiness, poor concentration, drowsiness, vomiting and double vision. If someone tells you that they experience any of these symptoms, you should advise them to attend the health centre immediately, so that their medication can be revised.

It is also important that you emphasise the importance of adherence to treatment. Advise the person (and their family) that they should never suddenly stop taking an AED because doing so could cause a new seizure. While taking AEDs, they should not take any other medicines, including traditional medicines, without consulting a doctor. This is because other medicines could cause a dangerous interaction with their AED and cause a seizure.

If the person remains seizure-free for more than two years, it may be possible for them to stop taking their AED. However, they should not do this until it has been agreed by the doctor.