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While there are several types of epilepsy medications that can be used, there are also complementary treatments.
Epilepsy is a neurological condition that causes patients to have seizures, caused by a sudden change in the electrical output of the brain. These electrical disturbances affect communication between brain cells. Seizures can be short, a momentary disruption of the senses, or they can lead to short periods of unconsciousness, staring spells, or even convulsions.
Some people have one type of seizure, while others have more than one type.
Epilepsy is treated with drugs to prevent seizures, but it cannot be cured. The goal of a treatment is to decrease the number and severity of seizures while minimizing the drug side effects to increase the quality of life for patients. Epilepsy medications have changed quite a bit over the years. A list of medications is available at the Epilepsy Foundation web site.
Some drugs work best for certain types of seizures, and some drugs work for one person but not another. Doctors must sometimes try several medications at different doses to find the correct treatment for a patient. Some older epilepsy medications are no longer used because they have many side effects, including drowsiness, mood changes, nausea, rash, clumsiness, slurring of speech, unsteadiness, double vision, weight gain, sleep disturbances, and hirsutism (excess hair growth).
Sometimes the drugs can actually increase the number of seizures, or a person can develop an allergic reaction to a medication.
Newer medications have been developed to avoid the more severe side effects seen with the older medications. Whenever possible, doctors try to find a single epilepsy medication to control a patient's seizures (monotherapy). However, sometimes a patient does not respond well to a single drug, and he or she may need to take two or more epilepsy medications (polytherapy). However, drug interactions can occur when patients take multiple medications. These interactions can increase or decrease the effectiveness of the medications, and are a cause for concern. Consequently, with each drug taken, more care must be used to prevent drug interactions.
Epilepsy medications work best when the drug levels remains at a constant, therapeutic level in the body. In other words, treatment works best when the patient is compliant (takes the medication on a regular schedule). However, as with any chronic disease where medication must be taken everyday for years, it can be difficult to be compliant with epilepsy, especially when taking more than one epilepsy medication. Yet when patients forget to take their medications, the drugs are less effective, and the patient may have more seizures. An alternative treatment that complements epilepsy medications is Vagus Nerve Stimulation. In this treatment, short bursts of electrical energy are delivered to the vagus nerve in the neck. The electrical energy comes from a battery, about the size of a silver dollar, which is implanted under the skin of the chest. Lead wires travel under the skin from the battery to the vagus nerve at the base of the neck. When the vagus nerve is stimulated by the battery it stimulates the brain. It is not yet clear how, but this small, regular stimulation of the brain via the vagus nerve decreases seizures in some patients that do not respond well to epilepsy medications. Patients still need to take their epilepsy medications in addition to the vagus nerve stimulation. It is much easier for patients to be compliant with vagus nerve stimulation because there is no need for the patient to do anything.
Patients must remember to take their epilepsy medication everyday, but the battery is in a pacemaker-like device that is programmed to send a short burst of electricity to the vagus nerve for a few seconds every few minutes. While there are a few side effects with vagus nerve stimulation, such as hoarseness and throat discomfort, these are mild and generally get better with time. In addition, the effectiveness of the treatment increases with time. In fact, there is not an immediate effect of vagus nerve stimulation, which is why patients must keep taking their other epilepsy medications.
Most patients also find that they have fewer seizures and a better quality of life after they have been receiving vagus nerve stimulation for some time. The bottom line is that vagus nerve stimulation is a useful complementary treatment for epilepsy patients that do not respond adequately to their epilepsy medications.
For more information about epilepsy, epilepsy medications and vagus nerve stimulation, visit the Epilepsy Foundation web site.
Read about VNS and Epilepsy from a patient's point of view.
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