According to the eHealthMD.com website, patients who suffer from seizures usually begin long-term treatment with anti-seizure medications after they have had two or three seizures. In most cases, the seizures respond to a single drug, and doctors choose that drug based on the type of seizure the patient is having. There are a group of seven commonly prescribed medications that cover most of the different types of seizures.
The Facts
Partial seizures are those involving only one side of the brain. In a simple partial seizure, the patient retains consciousness and in a complex partial seizure, consciousness is lost or impaired, according to The Epilepsy Foundation of America. Generalized seizures affect both sides of the brain and involve grand mal or tonic clonic, myoclonic, atonic and petit mal or absence seizures.
The eHealthMD.com website explains that carbamazepine is a good drug for partial seizures and for grand mal seizures in which the patient suffers from a stiffening and jerking of limbs.
Clonazepam can treat myoclonic seizures which are characterized by brief muscle contractions and atonic seizures which involve the abrupt loss of muscle tone.
Ethosuximide is useful for absence seizures wherein patients suffer a brief lapse of awareness that may be accompanied by staring. Phenobarbital can treat grand mal and simple partial seizures. Phenytoin works well for grand mal and simple and complex partial seizures. Primidone is a less effective alternative to phenobarbital. Valproate is the drug of choice for all generalized seizures.
Considerations
Patients who have bone marrow problems or the blood disorder porphyria should not take carbamazepine, according to Drugs.com. Porphyria is a condition in which the patient lacks one of the enzymes needed to make heme, a component of hemoglobin.
Women who are pregnant should know that there is evidence to suggest that valproate poses a risk to the fetus, according to the Mayo Clinic.
Patients should be aware that while they are taking phenytoin, they may experience changes in their behavior or mood and they may engage in suicidal thinking, explains MedlinePlus.
Warnings
Carbamazepine may compromise the patient's ability to fight infection and lower the blood platelet count, explains Drugs.com. A lower platelet count can lead to unusual bruising or bleeding.
According to the Mayo Clinic, patients on valproate may experience liver problems. Symptoms such as abdominal pain, dark urine, decreased appetite, fever, headache or yellow skin or eyes indicate that the patient should stop using valproate and consult a doctor.
Phenytoin may cause elevated blood sugar levels. Other common side effects may include uncontrollable eye movements, abnormal body movements and loss of coordination, according to MedlinePlus.
Clonazepam causes drowsiness in about half of those who take it. Other side effects include problems with balance and irritability.
Benefits of Anti-Seizure Drugs
It is possible for patients who are on anti-seizure drugs to discontinue use of the medication if they have not had a seizure for three years, according to eHealthMD.
Alternative Formulation of Phenytoin
Patients who take phenytoin three times a day in the tablet or liquid suspension form should know that there is a formulation called extended phenytoin sodium, brand name Phenytek, that allows once-a-day dosing.
