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January 24, 2012

Epilepsy Medications


EPILEPSY MEDICATIONS

It is not a topic people like to think about.  Epilepsy can be a fatal disorder. Individuals and families should be made aware of the extent of the risk. People can handle what they know. What they can't handle is what they don't know.

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Epilepsy is treated with drugs to prevent seizures, but it cannot be cured. The goal of a treatment is to decrease the number and severity of seizures while minimizing the drug side effects to increase the quality of life for patients. Epilepsy medications have changed quite a bit over the years.

But some people have may only have one type of Epileptic seizures, while others have more than one type.

Doctors must sometimes try several medications at different doses to find the correct treatment for a patient. Some older Epilepsy medications are no longer used because they have many side effects, including drowsiness, mood changes, nausea, rash, clumsiness, slurring of speech, unsteadiness, double vision, weight gain, sleep disturbances, and hirsutism (excess hair growth).

Sometimes the drugs can actually increase the number of seizures, or a person can develop an allergic reaction to a medication.

Medication treatment focuses on reducing the frequency and severity of seizures. People with Epilepsy may take several different drugs to control seizures, as no single drug controls all types. Some of the drugs used can include phenytoin (Dilantin®), valproic acid (Depacon™), Depakene®, Depakote®) and carbamazepine (Tegretol®), are commonly given.

For absence seizures, ethosuximide (Zarontin®) is preferred. Also sometimes added to a drug regime to help control seizures are Benzodiazepines (e.g., diazepam [Valium®] and lorazepam [Ativan®]). Benzodiazepines are a family of drugs used to treat seizure disorders, as well as panic attacks, muscle spasms, anxiety, and insomnia. About 10 to 20% of Epilepsy patients do not respond to treatment and may require surgery.

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Below is listed just a few of the more well known Antiepileptic medications. Brand name listed first followed by generic.  R following the brand name stands for Brand name XR following means it has extended release. Similar information can be found on www.drugs.com

ACTH : generic name: adrenocorticotropic hormone.  Treatment of Infantile spasms. ACTH has been used since the late 1950’s to treat infantile spasms although this use has not been submitted to the U.S. Food and Drug Administration for approval.  ACTH is given by intramuscular injections.

Carbatrol®:  generic name: extended release carbamazepine.  is used in the treatment of all types of partial seizures and in the treatment of generalized tonic clonic (grand mal) seizures.

Depakene/Depakote®/Depakote ER®:  generic name: valproate/valproic acid/divalproex sodium.  Treatment of partial or absence seizures by itself or as add-on therapy in adults and children 10 years and older. Though not FDA-approved, it is also effective in other primary generalized seizures. It is also used to treat mood disorders and headache.

Diamox®:  generic name: acetazolamide.  was introduced as an antiepileptic drug in 1952. It has been used to treat a variety of seizure types, including generalized tonic clonic, absence, and as add-on therapy for partial seizures. It may also be prescribed to treat catamenial epilepsy (epilepsy related to the menstrual cycle.

Diastat® Acudial™:  generic name: diazepam.  A gel preparation of diazepman for rectal administration in the treatment of cluster seizures or prolonged seizures in the patient who has refractory epilepsy.

Dilantin®:  generic name: phenytoin.  was developed in 1938 as the first modern antiepileptic drug and has been used ever since as first line therapy for partial and generalized tonic clonic seizures.

Felbatol®:  generic name: felbamate.  As single or add-on drug for partial seizures with or without secondary generalization in adults and children over the age of 14 years.

·    As single or add-on therapy for children 2 years or older and adults with Lennox-Gastaut syndrome

Gabitril®:  generic name: tiagabine.  treatment of partial seizures as add-on therapy in adults and children 12 years and older.

Keppra®:  generic name: levetiracetam.  was approved by the Food and Drug Administration in 1999 as an add-on therapy for partial seizures in adults.

Klonopin®:  generic name: clonazepam.  It may be prescribed for a variety of seizure types and syndromes, including absence seizures, myoclonic, atonic (drop attacks) and Lennox-Gastaut syndrome. It is most often used as an add-on drug to other antiepileptic drugs.

Lamictal®:  generic name: lamotrigine. Lamictal (La-MIC-tal) is used as add-on therapy for partial seizures (with or without secondary generalization) in adults and for partial and generalized seizures associated with the Lennox-Gastaut syndrome in children.

Lyrica®:   generic name: pregabalin.  Lyrica® (LEER-a-ka) is approved as add-on therapy in the treatment of partial onset seizures in adults.


 Mysoline®:  generic name: primidone.  is used to treat partial seizures with or without secondary generalization and generalized tonic clonic (grand mal) seizures. It is available in liquid and tablets.

Neurontin®:  generic name: gabapentin.  is approved in the U.S. as add-on therapy for partial seizures with or without secondary generalization (spread to become a grand mal seizure). It is available in capsules and tablets. This drug is not metabolized through the liver. The body gets rid of the unchanged drug through the kidneys.

Phenobarbital®:  This is the oldest antiepileptic drug in common use. A barbiturate, phenobarbital was first used as an antiepileptic drug in 1912. It is used for generalized tonic-clonic and complex or simple partial seizures in adults and children. It may also be used for myclonic seizures.

Phenytoin:  Phenytoin is an anticonvulsant drug which can be useful in the treatment of epilepsy. Phenytoin can be prescribed for those experiencing tonic-clonic (grand mal) seizures. Phenytoin is prescribed as capsules, tablets, and in syrup.

Tegretol®:  generic name: carbamazepine.  Tegretol (TEG-re-tol) is is used in the treatment of all types of partial seizures and in treatment of generalized tonic clonic (grand mal) seizures. It is usually described as a first line treatment. However, it is not effective and may even have negative effects for generalized absence and myoclonic seizures.

Tegretol-XR®:  generic name: extended release carbamazepine.  is used in the treatment of all types of partial seizures and in the treatment of generalized tonic clonic (grand mal) seizures. It is usually described as a first line treatment. However, it is not effective and may even have negative effects for generalized absence and myoclonic seizures.

Tegretol-XR is an extended release form of the drug, meaning that its active ingredient is released slowly in the body, avoiding the need for frequent dosing and large initial doses.

Topamax®:  generic name: topiramate.  is approved as an add-on medication for adults and children (2 to 16 years old) with partial seizures with or without secondary generalization or primary generalized tonic-clonic seizures and for seizures associated with the Lennox-Gastaut syndrome. It has been reported to be successful in myoclonic epilepsy and may have a role in the treatment of infantile spasms.

Tranxene®:  generic name: clorazepate. 

Trileptal®:  generic name: oxcarbazepine.  is related to Tegretol, TegretolXR, Carbatrol, and Epitol (carbamazepine). It was developed in an effort to combine the effectiveness of these related drugs with fewer side effects and drug interactions.

Valium®:  generic name: diazepam.  Because of its rapid entry into the brain, Valium is used in the treatment of status epilepticus (non-stop seizures).

Zarontin®:  generic name: ethosuximide.  Treatment of absence (petit mal) seizures

Zonegran®: generic name: zonisamide.  it was approved for use in the United States as an add-on drug for adults with partial seizures.


Ask yourself these questions

· How are you doing?

· Is your treatment working?

· Are you feeling as well as you'd like to feel?

· How much of an effect is Epilepsy having on your life?


Maybe you feel that it is time to check with your Health Care team to see whether there may be other medicines, new devices, or other treatments that might offer better answers to how you are feeling and coping.

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