If I develop epilepsy, what treatments are available?
Most people who develop post-traumatic epilepsy need to be treated with medicines to stop the seizures. The doctor’s goal should be to completely stop the seizures without producing “bad” side effects. However, we know that the medicines will not always be effective. Only about one half of people who develop post-traumatic epilepsy will likely become seizure-free on current medications. Sometimes stopping seizures can be achieved at the cost of side effects, so deciding on how best to treat any given person is often a “team” decision between the doctor, the patient and the patient’s family.
There are more than ten medicines that can be used. As far as we know, all are about equally effective, but they have different side effects. Some of the medicines, like dilantin (phenytoin), tegretol (carbamazepine) and depakote (divalproex sodium) have been around for many years. They work well and are often less expensive than some of the newer seizure medicines. But they may have side effects that the newer medicines do not have. Medicines like lamictal (lamotrigine), neurontin (gabapentin), lyrica (pregabalin), keppra (levetiracetam), topamax (topiramate), zonegran (zonisamide), trileptal (oxcarbazepine), and gabitril (tiagabine) can all be effective and may be better tolerated than some of the older medicines. Phenobarbital, an older antiseizure drug, is also effective, but because it often causes sleepiness, and it isn’t used as much.
When seizures are not completely controlled by one medicine, the doctor may try combinations. As more medicines are added, side effects may increase, so there is always a tradeoff. That’s why communication between doctor and patient is so critical.