7 Benefits of Changing Epilepsy Treatment

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Jennifer Larson on November 21, 2022
  • yellow-pills-among-green-pills
    Time to change?
    If your epilepsy treatment works just fine, there’s no reason to tinker with it. If it ain’t broke, don’t fix it, as the old wives’ tale goes. But if you’re having difficulty treating your epilepsy or are dissatisfied with the treatment, it may be time to consider switching to another one. For some, a new medication or set of medications may be just the ticket, while for others, surgery may be the best route.
  • Smiling Black man
    1. You could gain better control of your seizures.
    Gaining more control of your seizures is probably the biggest reason to switch your epilepsy treatment. According to the Epilepsy Foundation, medication can effectively control seizures in about seven out of 10 people. But some medications work better for certain kinds of seizures, so it’s important to not give up if the first or even the second medication you try isn’t very effective.
  • woman with headache
    2. You might experience fewer side effects.
    Unfortunately, many antiepileptic drugs (AEDs) are known for causing side effects. They can range from fatigue and sleepiness to nausea and vomiting to headaches to dizziness and confusion. Some people experience a marked decrease in appetite or rashes. There are also more serious side effects such as a drop in your levels of white blood cells or platelets, as well as damage to your liver or pancreas.  You may have better luck with a different type of medication—or combination of medications—or other type of treatment.
  • depressed male sitting on couch looking away
    3. You could reduce your risk of developing depression.
    A more serious side effect of many anticonvulsants is depression. Some research suggests that vigabatrin and topiramate tend to be linked to depressive symptoms more than other medicines, although it can vary. Meanwhile, other meds, such as sodium valproate, ethosuximide, carbamazepine, oxcarbazepine, phenytoin, gabapentin, pregabalin and lamotrigine, seem to present a lower risk of causing depression. If you find yourself developing suicidal thoughts or other signs of depression, don’t wait to speak up. Talk to your doctor so you can discuss some other method of treatment that won’t cause this problem.
  • woman-with-headache
    4. You may have fewer migraine headaches.
    Migraines affect about 37 million people in the United States. If you’re one of them, you might be able to take a medication for your epilepsy that also reduces the incidence of these painful, debilitating headaches. Three anticonvulsants sometimes used to reduce migraine headaches are divalproex, gabapentin, and topiramate.
  • Birth control pills
    5. You need a treatment that won’t interact with your contraceptive
    Some AEDs do reduce the effectiveness of birth control pills, a very serious concern for women of child-bearing age—be wary of taking carbamazepine, phenytoin, phenobarbital primidone, oxcarbazepine, topiramate, felbamate or perampanel. If you do not want to become pregnant, talk to your doctor about another antiseizure drug or ask if another method of treatment might be more appropriate for you.
  • surgery
    6. You might get better management of your seizures with surgery.
    Between 20 and 30% of people with epilepsy find that medication alone—even a combination of meds—does not effectively manage their seizures. Surgery is an option for some of them—notably, the ones whose seizures originate in a part of the brain that can be removed without affecting speech and language, vision, hearing or motor function. Some studies suggest that the earlier the surgery is performed, the better the outcome is likely to be. There is also surgery that can be performed on parts of your brain that can’t be removed, which is designed to keep seizures from spreading to other parts of the brain. Note: you may still need medication after surgery but perhaps not as much.
  • surgeon and radiologist viewing digital brain scan in hospital
    7. You may gain better control of your seizures with an implanted device.
    Medication alone might not be useful, and you might not be a candidate for surgery. You might opt for one of the two devices that are available for implantation. The vagus nerve stimulation (VNS) device, which is implanted in your chest, sends a mild pulse of energy through your vagus nerve to your brain. The responsive neurostimulation (RNS) device is implanted inside your skull with leads placed on the seizure target. It records your brain’s activity, and when it notes a pattern that looks like it might be the precursor to a seizure, the neurostimulator sends pulses of energy to disrupt the pattern.
7 Benefits of Changing Epilepsy Treatment
  1. Epilepsy Treatment. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/epilepsy/diagnosis-treatment/treatment/txc-20117241
  2. Goldenberg MM. Overview of Drugs Used For Epilepsy and Seizures: Etiology, Diagnosis, and Treatment. Pharmacy & Therapeutics. 2010 Jul; 35(7): 392–415. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2912003/
  3. Ko DY. Epilepsy and Seizures Treatment & Management. Medscape. http://emedicine.medscape.com/article/1184846-treatment
  4. Mula M and Sander JW. Negative effects of antiepileptic drugs on mood in patients with epilepsy.  Drug Safety. 2007;30(7):555-67. http://www.ncbi.nlm.nih.gov/pubmed/1760440
  5. Responsive Neurostimulation. Epilepsy Foundation. http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/devices/responsive-neurostimulation
  6. Side Effects: Seizure and Epilepsy Medication. Epilepsy Foundation. http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/seizure-and-epilepsy-medicines/side-eff...
  7. Surgery: Treating Seizures and Epilepsy. Epilepsy Foundation. http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/surgery
  8. Vagus Nerve Stimulation. Epilepsy Foundation. http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/devices/vagus-nerve-stimulation-vns
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Last Review Date: 2022 Nov 21
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