Essential Guide to Safe Medication Practices for People with Epilepsy

As a physician assistant specializing in neurology and epilepsy, our team receives many questions about seizure medications. Patients ask about potential side effects, how these medications might interact with others and, in some cases, how certain medications might cause seizures.

What’s the difference between a seizure and epilepsy?

A seizure is a sudden and uncontrolled electrical disruption in the brain that can affect your behavior, movements, sensations or level of awareness. Some seizures are so mild they may go unnoticed, while others can be completely disabling.

Epilepsy, also called seizure disorder, is a condition usually diagnosed when someone has at least two unprovoked seizures. An unprovoked seizure happens without a clear cause, such as a head injury, infection or another identifiable trigger. Epilepsy is the fourth most common neurological disorder and affects people of all ages.

What are the available treatment options for epilepsy? 

Epilepsy is a challenging condition, but many treatment options can help manage it and improve a person's quality of life. Each treatment plan is tailored to the individual, and the options may include the following:

• Medications - Anti-seizure medications calm the brain’s electrical activity to help prevent seizures. They are chosen based on age, seizure type and health history.
• Diet changes - High-fat, low-carbohydrate diets may reduce seizures, especially when medications are not enough, but should be supervised by a doctor or dietitian.
• Lifestyle modifications - Daily habits such as getting enough sleep, managing stress and limiting alcohol can help reduce seizure triggers and improve seizure control.
• Medical devices - Vagal Nerve Stimulation (VNS), Responsive Neurostimulation (RNS) and Deep Brain Stimulation (DBS) are devices that can help manage drug-resistant seizures by controlling or interrupting abnormal brain activity to reduce their frequency and severity.
• Surgery - For extreme cases, surgery to remove the seizure-causing brain area can reduce or stop seizures when other treatments fail.

What medications are used to treat epilepsy?: 

Anti-seizure medications, also known as anticonvulsants, are the most common way to treat epilepsy. These medications help control seizures by calming irregular electrical activity in the brain. There are many types of these medications, and doctors choose the best one based on factors like your age, the type of seizures you have and your medical history. Sometimes, it takes trying different medicines or combinations to find the best for you.

Doctors have a variety of anti-seizure medications to choose from, and they select the best one based on a patient's seizure type, overall health and possible side effects. They also take into account other medications the patient is using. Doctors can change the medication plan to meet the needs of people treated for other health conditions. Sometimes, it takes trying several medicines or combinations to find the most effective option.

What medications should you discuss with your provider and use with caution in epilepsy?

• Diphenhydramine - The active ingredient in Benadryl and other medications used to treat allergies or colds. It’s also commonly found in over-the-counter sleep aids and nighttime cold medicines.
• Pseudoephedrine - A type of medication called a decongestant. Decongestants reduce swelling in the blood vessels in your nasal passages, which helps you breathe more easily. Pseudoephedrine is the active ingredient in products like Sudafed and medications with a “D” at their name, such as Zyrtec-D, Claritin-D or Mucinex-D.
• Bupropion - Known by the brand name Wellbutrin, is a medication used to help people quit smoking and to treat depression.
• Tramadol or Ultram - A prescription pain reliever often given to manage mild to severe pain.
• Oral contraceptives - Could be less effective if taken with certain seizure medicines, or they could reduce the effectiveness of the seizure medication.
• Certain antibiotics - Potentially interfere with seizure medications or cause other interactions.

If you have epilepsy, it’s important to talk to your doctor or pharmacist before combining seizure medications with other prescriptions. This helps ensure your medications stay safe and work as they should. Knowing how your medicines affect each other is a key part of your treatment plan.

Managing epilepsy isn’t just about taking medications. It also means focusing on your overall health and getting enough sleep, staying calm under stress and understanding what might trigger a seizure. These habits can lower your risks and help you feel more in control of your condition.

Your neurological team is here to support you every step of the way. Lean on them for expert guidance and trust them to address any health concerns you may face.