There are many medicines that treat seizures. But, seizure medications do not cure seizures, they control seizures. Some medications only work to control for specific types of seizures. Other medications work to control a wide variety of seizure types.
Choosing the Right Medication
Choosing the right medication depends on a number of factors including:
Type of seizure a child has
Age of the child
Other medical problems the child has
Other medicines the child takes
Side effects of the medicine
Seizure Medication Safety
It is important to understand how to properly take a seizure medicine. Some medications are given once a day while others are given twice or three times a day. Rarely, seizure medications may be given up to four times per day. Knowing both the brand name and generic name, the dose, and when to take the medication is very important. Additionally, being familiar with possible side effects of the medication and any necessary blood tests while on the medication is helpful.
Only a few of the widely used medications used to treat seizures are approved by the FDA for use in children. Your doctor can tell you the details of your child's specific medication including the indications for use and its safety profile.
Types of Seizure Medication
There are many different types of seizures and some medications work better for certain seizures types. Some common seizure types include focal, generalized tonic-clonic, and absence. There is also a growing number of newer medications that can be used to treat specific types of seizures.
Common medications used for generalized tonic-clonic seizures include:
Note: Many of these medications are also used to treat focal seizures.
Common medications used for focal seizures include:
The most classic medication used for absence seizures is ethosuximide, but valproate is also commonly prescribed.
Side Effects from Seizure Medications
All medications, even over-the-counter medicines, have the risk of side effects. Therefore, all seizures medications have some risk of side effects. Most children have few or no problems with side effects from seizure medications. Side effects vary by medication but may include:
Some less common side effects are hard to see and may affect the liver, kidneys, or blood cells. To monitor for these side effects, blood work may be done. Some side effects occur more often at higher doses and may be avoided if a lower dose of the medication can be used.
When a child shows signs of a potential side effect from a seizure medication, it is important to consider other possible causes of that side effect. For example, a rash may be due to a viral illness or an exposure and may not be due to a seizure medication. However, because rare cases of serious rashes from seizure medications can occur, it is important to watch carefully and notify your child's primary care doctor and epilepsy doctor in the event of a rash.
Some seizure medication affects how children build strong bones. This problem is especially important for children who need to take certain seizure medications for many years. If your child needs seizure medicines for more than a year or two, ask your doctor if they need to be monitored for bone health.
Interactions with birth control
Teen and young adult epilepsy patients should be aware that some seizure medications can interact with certain forms of birth control. This can result in abnormally high or low levels of the seizure medication or ineffectiveness of the birth control medication. This can lead to poor seizure control and/or an unintended pregnancy.
Seizure medications during pregnancy
Women who are taking certain seizure medications when they become pregnant have an increased risk of having a baby with birth defects. Some medicines are safer than others during pregnancy. Pregnancy also changes the way a woman's body metabolizes seizure medicine, so doctors monitor pregnant patients very carefully. It is important to discuss seizure medication choices with your doctor prior to becoming pregnant, if possible.
Long-term Seizure Medication
Parents often worry about giving a child medication every day to prevent seizures. It is important to know that seizure medications are usually very successful in preventing seizures and with proper monitoring they are quite safe. A child who has uncontrolled seizures is at risk of a variety of dangers including injury from falls, accidents, drowning, or even death. See Seizure Safety: Tips for Parents.
If your child has epilepsy, you should also talk with your doctor about rescue medications. Rescue medications are used when a child has a very long seizure (usually 5 minutes or longer) or has a cluster of multiple seizures in one day. There are a variety of options for rescue medications. These include medications that are given as a dissolving tablet, a rectal gel, or a nasal spray. Some commonly prescribed rescue medicines are diazepam, clonazepam, and midazolam.
Additional Information from HealthyChildren.org: