Anti-seizure medication

Some anti-seizure medications are more suitable for different seizure types than others. Read more about the different types of seizures. The following is a guide to the main anti-seizure medications used for different seizure types:

All anti-seizure medication can have side effects but the majority of people don’t get side effects.

• Some side effects may impact on your lifestyle more than others and they can be life-threatening.
• Common side effects when starting anti-seizure medication include tiredness, feeling sleepy, dizziness, dry mouth, feeling sick (nausea), diarrhoea (runny poos) and stomach upset. These usually go away as your body gets used to the medicine. 
• Life-threatening side effects that are possible with some anti-seizure medication include severe skin reactions, problems with your liver and problems with your blood cells such as your white blood cells or platelets.

Talk to your healthcare provider about possible side effects of your medicines. To help reduce your chance of side effects, your healthcare provider may:

• start you on a low dose, then gradually increase it – this allows your body to slowly get used to the medicine
• ask you to have blood tests to make sure you’re taking the right dose and check you don't have serious side effects. 

 Read more about medicines and side effects and reporting a reaction you think might be a side effect. 

The decision about when to start medication can be difficult. One seizure may not mean that you will have another, and a second seizure may not occur until years later. 

A common option after a first seizure is to wait and see. If you have a second seizure within a few months more are likely, so it may be a good idea to think about starting anti-seizure medication.

Assessing the benefits and risks

The decision to start anti-seizure medication should be made by thinking about the benefits and risks of starting the medicine. This will depend on how your seizures affect you and how often they happen.

The following are risks and benefits of ASMs to think about before making your decision.

Risks of taking anti-seizure medicines

• Having side effects from the medicine.
• Needing to remember to take your medicine regularly. 
  
  

Benefits of taking anti-seizure medicines

• Reducing or stopping your seizures so they don’t interfere with your day-to-day life. Up to 70% (7 in 10) of people with epilepsy could have their seizures completely controlled with anti-seizure medications.
• Reducing the chance of accidents or injuries that can happen when you have a seizure.
• Reducing your worry that you’ll have a seizure.
• Reducing the chance of getting status epilepticus. This is when you have seizures that continue without stopping, or a series of seizures that happen for 30 minutes without you recovering in between. This can happen with any seizure type.
• Reducing the chance of SUDEP (sudden unexplained death in epilepsy patients). Read more about SUDEP(external link).

Deciding on which anti-seizure medication is best for you depends on many things, such as:

• your type of seizures
• your type of epilepsy
• your age
• the possible side effects of the anti-seizure medications and how they might impact on your lifestyle  
• other medicines you're taking for other conditions, and possible interactions with these
• whether you're planning a pregnancy – read more about epilepsy and contraception
• whether you're pregnant. Read more about:
  • epilepsy and pregnancy
  • the risks and benefits of taking anti-seizure medicines if you are pregnant or planning a pregnancy(external link)
  • medicines for epilepsy, mental health and pain can harm your unborn baby(external link)
  • epilepsy medicines and pregnancy.(external link)

Your healthcare provider can discuss the best medicine for you. It may take some time to find the anti-seizure medication that works best for you. 

In most cases, only 1 anti-seizure medication is needed to prevent seizures, but some people may need 2 or more medications.

Anti-seizure medications (ASM) are usually available as tablets, capsules and liquids. If you find taking tablets difficult, ask your doctor to prescribe you something easier to swallow – some tablets can be chewed or crushed.     

ASM is usually taken once or twice each day. Sometimes it's taken 3 times a day. It’s important to take it regularly, as prescribed by your healthcare provider, because missing a dose can increase the risk of having a seizure. Read more about tips for remembering to take medicine.

Once you're taking anti-seizure medication, it’s a good idea to get advice about what to do if you ever forget to take it. The advice your healthcare provider gives you when you miss a dose will depend on which epilepsy medicine you're taking, and how many times a day you take it.

Anti-seizure medicines don't cure epilepsy, but they can stop the seizures from happening. For some people, having epilepsy is a lifelong condition and they will need to continue taking medication.

If you haven't had a seizure for 2 or more years, you may want to discuss coming off your treatment with your doctor. It will depend on several things, including the possible impact of seizures returning.  

Coming off ASM

When coming off anti-seizure medication, it's important to do it slowly. Stopping treatment suddenly is dangerous – it can cause seizures to start again, or happen more often and last longer than before.

You can plan with your doctor:

• how to come off the medication slowly
• what to do if your seizures start again.

If seizures do start again and you go back on medication, you may have to start at a low dose again until your body gets use to it. Always talk to your healthcare provider before re-starting anti-seizure medication.