Drugs to Avoid in Epilepsy

As a physician assistant who specializes in neurology epilepsy, our multi-disciplinary team receives many questions surrounding the medications that may be prescribed to control seizures, including potential side effects, how medications may interact with other types of medications, and even how certain medications might cause seizures.

You may be wondering, what is a seizure, and what is epilepsy?

A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in your behavior, movements, or feelings, and in levels of consciousness. Some seizures can hardly be noticed, while others are totally disabling.

Epilepsy, or seizure disorder, is a chronic disorder that is usually diagnosed after a person has two unprovoked seizures. It is the fourth most common neurological disorder that affects people of all ages.

There are many options for epilepsy treatment:

• Medications
• Diet changes that may include ketogenic or modified Atkins diet
• Lifestyle modifications that manage potential seizure triggers like sleep deprivation, stress and infection
• Devices that include vagal nerve stimulator, responsive neurostimulation and deep brain stimulation
• Surgery

Medications for epilepsy include: 

• Many different anti-seizure medications are available, which are typically chosen based on the patient’s type of seizure disorder, side effects, other health conditions and medication use of the patient 
• Medication regimen can also be tailored based on other conditions for which the patient is being treated 

Patients should always work with their neurologist to choose the best treatment or medication for optimal seizure control and minimal side effects.

Medications that may cause seizures:

• Diphenhydramine - the active ingredient in Benadryl and other medications that treat colds or allergies. It is also a common ingredient in over-the-counter sleep aids and nighttime medications.
• Pseudoephedrine - a decongestant that shrinks blood vessels in the nasal passages. This is the active ingredient in medications like Sudafed and any medications with “D” on the end (Zyrtec D, Claritin D or Mucinex D).
• Bupropion - also known as Wellbutrin, which is used for smoking cessation and as an anti-depressant.
• Tramadol or Ultram - a pain reliever commonly prescribed to treat moderate to severe pain.
• Oral contraceptives - which may reduce the effectiveness of your seizure medication or your seizure medication may reduce the effectiveness of your oral contraceptive.
• Certain antibiotics

If you have epilepsy and take medications, it is important to discuss the way your prescriptions might interact with other medicines. Getting regular sleep, controlling stress, and managing potential seizure triggers are all important aspects of successfully managing epilepsy. 

Your neurological team will be your allies along the way and can be counted on to appropriately advise you on any health concerns that you may have.