How to find The Right Epilepsy Medication
The goal in treating epilepsy is to control your seizures so you can focus on life again. The number of treatments available has increased over the past 20 years. Today your doctor has access to more than 20 drugs.
Your doctor will take into account a number of factors in order to find the best drug.
- The type of seizures you have
- Additional medical conditions that you may have
- Additional drugs that you may be taking
- You insurance coverage
Your medical history and tests like an EEG (electroencephalogram) and MRI (magnetic resonance imaging) can help your doctor learn what kind of seizures you're having.
"Some seizures start in just one part of the brain [focal onset seizures] and some start with the whole brain firing off at the same time [generalized onset seizures]," says Adam Hartman, MD, director of basic epilepsy research at the Johns Hopkins Children's Center. "We think about which medication is most likely to work for a particular patient's seizures."
Conditions of Health
Other health issues are also important. You may need to be aware that epilepsy medications can interfere with your current medication. Some drugs can also be used to treat another condition. For example, topiramate (Qudexy XR, Topamax, Trokendi XR) can help both seizures and migraine headaches. Lamotrigine (Lamictal) can treat epilepsy plus bipolar disorder.
Generics and. Generics vs.
Also, the doctor will discuss with you which drugs your insurance will pay for. Generic medications are usually cheaper than those of brand-name drugs. They work, but are they as effective?
Generally, yes. FDA demands that generic drugs contain the same active ingredient and strength as brand-name medications. However, generic versions can be quite different from each other.
To get the lowest prices on generic drugs, big-chain pharmacies may switch to them more often. This could mean that you might be pushed from one drug to the next. Patients are told that they can only go generic if their pharmacy guarantees them the exact same product. Imad Najm MD, Director of the Cleveland Clinic's Epilepsy Center, says:
Beginning on a medicine
Consider all the factors before your doctor prescribes a medicine. Hartman states that doctors usually start patients with the lowest dose of a drug. "If someone's seizures are well controlled with a low dose of medication, that's the dose we use."
Once you're on a drug, you'll wait to see if your seizures improve. "To judge whether the medication is working, we need to look at seizure frequency," Najm says. If you have seizures every day, you should be able to tell within a month if the medicine has relieved them or made them less frequent. For seizures that come only once every few months, you'll have to stay on the medicine longer to see an effect.
About half of people will be seizure-free with the first drug they try. If your seizures don't get better or they only improve a little, your doctor will increase the dose, switch you to a new drug, or add a drug.
If you are unable to tolerate side effects (which can be anything from nausea and fatigue to mood changes) it is possible to switch medications. Devon Wolski was 6 years old when her father diagnosed her with epilepsy. Her doctor prescribed levetiracetam (Keppra or Spritam) to treat her condition. She didn't stick with the drug long. Wolski claims that it made Wolski's little girl a complete monster. She was extremely moody and easily irritable."
Newer epilepsy medications like Cenobamate, OxtellarXR, Trileptal, and pregabalin are generally less side-effects than older drugs such as Carbatrol, Epil, Epil, Equetro. However, any medication can lead to side effects.
The Time When Medicines Do Not Work
After trying one to three epilepsy drugs, about two-thirds of people find relief from their seizures. What if you're among the one-third of people whose seizures don't improve?
Hartman says, "After this the odds of success drop." "This is where we think about alternate therapies."
Surgery, neurostimulation (an implanted device that disrupts abnormal electrical signals in the brain to stop seizures), and a ketogenic diet are all options if medicine hasn't been effective. To test new drugs for epilepsy, you can join clinical trials.
How to get the best out of your treatment
You can increase the chances of success by following all instructions. Report any side effects to your doctor immediately. Don't stop taking the drug. Hartman states, "Remember this is a partnership." "Every side effect must be addressed."
It can take some trial and error to find the treatment that strikes the right balance of seizure relief and side effects. Devon tried several different combinations of drugs and dosages with her doctor.
She is now taking valproic acid as well as lamotrigine. It seems that it's working. "She's been seizure-free for a year and a half," Wolski says. She's a normal child. She is the same girl that she would be without epilepsy.