Epilepsy is a medical condition caused by nerves in the brain firing rapidly in a disorganized fashion. According to the Epilepsy Foundation, it occurs in an estimated 3 million Americans and may be characterized by physical convulsions and loss of consciousness. Depending upon the specific type of epilepsy, the disorder may be effectively treated by one or more of several different types of anti-convulsant, or anti-epileptic, drugs (AEDs).
Phenytoin
Phenytoin is used for the treatment of seizures in adults and children. Because it has a number of side effects, it has become less popular among neurologists but is still the most commonly used AED among general practitioners. It appears to work by controlling sodium channels in the brain and may cause side effects, such as an unsteady gait, jerky eye movements and nausea. Long-term side effects include hair growth and overgrowth of the gums. In addition, most patients will need periodic blood testing to monitor serum concentration levels, and generic substitution is not recommended.
Valproic Acid and Sodium Valproate
Valproic acid and sodium valproate, known as broad-spectrum AEDs, are useful for many different types of epilepsy in adults and children over the age of 3. Valproic acid may work by interacting with GABA receptors and by changes in calcium channels. Common side effects include weight gain, stomach upset, tremor and drowsiness. Valproic acid may also cause more serious side effects, including bone loss, liver or pancreatic damage and changes in blood cell functioning. Use of valproic acid may require periodic laboratory testing to check for these changes.
Carbamazepine
Carbamazepine is commonly used for partial seizures in adults, children and infants. It works by inhibiting rapid firing of brain cells by interfering with sodium channels. Common side effects of carbamazepine may include stomach upset, weight gain, dizziness and blurry vision. Most physicians will require occasional laboratory testing to check for rare but potentially serious conditions, such as blood, renal or liver disorder.
Oxcarbazepine
Oxcarbazepine, a newer derivative of carbamazepine, is also used for the treatment of partial seizures in adults and children as young as 4 years, along with use as a mood stabilizer in the treatment of bipolar disorder. Epilepsy.com states that side effects may be less common than those of carbamazepine but may include stomach complaints, headache and dizziness. It is more commonly thought to cause dehydration, and any skin changes, breathing difficulties or symptoms of dehydration should be reported to a physician immediately.
Topiramate
Topiramate may be used for most types of epilepsy in both adults and children. Topiramate may work by increasing the acidity of brain tissue and by blocking an enzyme in the brain known as carbonic anhydrase to reduce seizure activity. Common side effects include changes in foggy thinking, memory difficulty and drowsiness. Changes in eyesight may indicate the development of changes in eye pressure, known as glaucoma, and may need immediate medical attention.
Levetiracetam
Levetiracetam is used for the treatment of a wide variety of epilepsy types in both adults and children. Its use has become more common, as it is less likely than other medications to cause problems with thought process or memory. Common side effects may include dizziness, fatigue, irritability and mood changes. As with any seizure medication, severe or persistent side effects should be reported to a physician.
Lamotrigine
Lamotrigine, a broad-spectrum AED, is considered to be a good alternative to valproic acid. Side effects commonly seen may include headache, dizziness, fatigue and the development of a rash. It may take several months to become accustomed to this medication, and doses must be increased slowly. Lamotrigine is also used as a mood stabilizer for the treatment of bipolar disorder.
Pregabalin
Pregabalin is used for epilepsy and for the treatment of chronic pain and works by interfering with GABA receptors in the brain. Common side effects include sedation, weight gain, unsteady gait, fatigue and dizziness. Pregabalin is approved only for use in adults.
