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Anti-seizure medicines (ASM) are not a cure for epilepsy, they control or reduce seizures.
ASM work by stabilising the electrical activity of your brain.
Up to 70% (7 in 10) people with epilepsy could have their seizures completely controlled with anti-seizure medicines.
Read more about epilepsy(external link).
There are several different anti-seizure medicines available in New Zealand.
| Commonly prescribed anti-seizure medicines |
Use effective contraception when taking sodium valproate (Epilim ®)The anti-seizure medicine sodium valproate is not suitable for people who could become pregnant, or who could father a child. If you’re a woman of child-bearing age and could possibly get pregnant, you should avoid valproate, if possible. If you use it during pregnancy, there's a risk of harm to your unborn baby, as well as long-term developmental disorders once they are born. If valproate is the best choice for you despite this, it’s important you understand the risks. Talk to your healthcare provider about this and ensure you use two methods of effective contraception so you avoid unplanned pregnancy. If you can father children, talk to your healthcare provider about the potential risks to a child while you're taking sodium valproate and for 3 months after you've stopped taking it. It's important to ask about options and plan ahead if you wish to start a family. Note: All anti-seizure medicines have the potential to harm an unborn child, but the risks are higher with sodium valproate than some other medicines, especially early in your pregnancy and if you're taking higher doses. Read more about epilepsy and pregnancy and epilepsy and contraception. |
| Other anti-seizure medicines | |
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Some anti-seizure medicines 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 medicines used in different seizure types:
| Type of seizure | Anti-seizure medicines options |
|---|---|
| Absence seizures | sodium valproate, ethosuximide, lamotrigine |
| Myoclonic seizures | sodium valproate, clobazam, levetiracetam, topiramate |
| Atonic and tonic seizures | sodium valproate, lamotrigine |
| Generalised tonic-clonic seizures | sodium valproate, lamotrigine, carbamazepine, oxcarbazepine, levetiracetam, clobazam |
| Focal seizures | carbamazepine, lamotrigine, sodium valproate, levetiracetam, oxcarbazepine, topiramate, lacosamide |
All anti-seizure medication can have side effects but the majority of people don’t get side effects.
Talk to your healthcare provider about possible side effects of your medicines. To help reduce your chance of side effects, your healthcare provider may:
Read more about medicines and side effects and reporting a reaction you think might be a side effect.
The decision of when to start medication can be difficult. One seizure may not mean that you will have another seizure and a second seizure may not occur for 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.
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 table includes what you might want to think about to help you make your decision:
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Benefits of taking anti-seizure medicines |
Risks of taking anti-seizure medicines |
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Deciding on which anti-seizure medicine is best for you depends on many things such as:
Your healthcare provider can discuss the best medicine for you. It may take some time to find the anti-seizure medicine that works best for you.
In most cases, only one anti-seizure medicine is needed to prevent seizures, but some people may need two or more medicines.
Anti-seizure medicines (ASM) are usually available in tablets, capsules and liquids. If you find taking tablets difficult, ask your doctor to prescribe you something easier to swallow – some tablets are chewable or crushable.
ASM medicine 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 medicine, 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 with your doctor about the option of coming off treatment. This will depend on several things, including the possible impact of seizures returning.
When coming off anti-seizure medicines, it's important that it's done slowly. Suddenly stopping treatment 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 and decide 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 the medicine. Always talk to your healthcare provider before re-starting anti-seizure medication.
The following links provide further information about anti-seizure medication. Be aware that websites from other countries may have information that differs from New Zealand recommendations.
Medicines for epilepsy, mental health and pain can harm your unborn baby(external link) ACC, NZ
Epilepsy(external link) Better Health Channel, Australia
New to epilepsy treatment(external link) Epilepsy Society, UK
About epilepsy: the basics(external link) Epilepsy Foundation, US
Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.
Reviewed by: Stephanie Yee, Pharmacist, Auckland
Last reviewed:
