Antiepileptic drugs are prescribed to treat various types of seizures related to epilepsy. They come in many forms and are not available without a prescription.
- Also known as AEDs.
- Treat symptoms related to epilepsy.
- Are effective for about 70% of people.
If you are concerned about epilepsy or would like to discuss antiepileptic drugs with a doctor, you can make an appointment to speak to one of our registered clinicians via our online video consultation service, which is available from 9.30am-4.30pm, five days a week.
What are antiepileptic drugs?
Antiepileptic drugs come in many forms, all of which treat seizures related to epilepsy. For the majority of people, these drugs are highly effective, but they’re not beneficial in all cases, and other treatments may need to be considered.
What is epilepsy?
Epilepsy is a fairly common condition in the UK that can begin at any age, although it’s more likely to present in childhood or among people over the age of 60. The condition is lifelong, but in many cases it improves over time. Symptoms can vary from person to person, depending on the part of the brain that’s involved. Typical symptoms include uncontrolled jerking, stiffness, staring into space, collapsing, or a strange ‘rising’ sensation in the stomach. Some people may pass out having had a seizure, and have no recollection of what happened.
What causes epilepsy?
Epilepsy is caused by a disruption of the electrical signals of the brain, which result in short bursts of energy that trigger seizures. For the majority of people with the condition, it is not known why this occurs, but damage to the brain can cause the condition. This includes damage sustained from strokes, tumours, infections, drug abuse, alcohol abuse, birth trauma or a head injury.
Seizures are triggered by various things, but typically, stress, poor sleep, alcohol, certain medications or illegal drugs, flashing lights and the menstrual cycle are factors. Keeping a diary can help you pinpoint your specific triggers and when they occur, and help you to avoid them where possible.
How is epilepsy diagnosed?
Diagnosis starts with seeing your GP, who may then refer you to a specialist (usually a neurologist). They may want to run other tests to determine whether your symptoms are caused by epilepsy. This is because it shares symptoms with other conditions, such as panic attacks and migraines.
During your assessment, you will be asked to describe a seizure, when it happened, what you were doing before it happened and how you felt before and after it. If someone witnessed the attack, having them describe what they saw may also be helpful. Tests involve an EEG (electroencephalogram), which measures electrical activity in the brain.
Another option is an MRI scan (magnetic resonance imaging), which can spot any damage in the brain or highlight tumours that may be present.
How is epilepsy treated?
Treatment may vary, depending on the triggers, cause and severity of the condition, but in most cases, epilepsy can be well managed. Antiepileptic drugs cannot cure the condition, but 70% of people who are prescribed them see significant improvements in their symptoms. You will need to take these medications daily in order to manage the condition, starting at a low dosage and increasing it gradually, until your seizures stop.
Coming off antiepileptic treatments needs to be done slowly, and with advice from your GP. It is essential that you do not stop suddenly, even if you have not had any symptoms for a long time. If medication proves to be ineffective, removing a small part of the brain that is causing the issue may be considered. Another option is an electrical device implanted in the body that helps control seizures when they occur.
What you can do to help treat epilepsy
Living with epilepsy presents many challenges, but there are some practices that don’t require medication that can help. A special diet, called the ketogenic diet, can help prevent seizures. The diet consists of a high amount of fats and low carbohydrates. Seeing the warning signs before a seizure occurs may also be helpful.
Avoiding triggers, and recording when they do occur in a diary, can help you reduce the risks of seizures (it should be noted that flashing lights, contrary to popular belief, are not a common trigger for most people). Regular reviews with your GP or a specialist is another key element of managing the condition, which should take place at least once a year. During these assessments, you will be able to discuss any issues you are having with your treatment and any adjustments that have been made.
It’s good practice to have a smoke detector fitted if you are at all susceptible to seizures, as they can occur whilst you are cooking. Guard rails may also be recommended for certain appliances, while having a shower instead of a bath may reduce your risk of drowning as a consequence of a seizure.
If you would like to speak to a GMC-registered clinician about epilepsy, our online video consultation service is available from 9.30am-4.30pm, Monday to Friday. They can also issue referrals to specialists for treatment, and provide fit notes, where suitable.
What side effects does epilepsy treatment have?
Because there are many different types of antiepileptic medication available, side effects may vary from one drug to another. You should therefore discuss any concerns you have with your prescribing doctor. One of the most commonly prescribed antiepileptics is carbamazepine, the side effects of which include:
More than 1 in 10 people have experienced: leucopenia, dizziness, tiredness, unsteadiness, difficulty controlling movement, feeling or being sick, changes in liver enzyme levels and skin reactions.
Up to 1 in 10 people have experienced: a tendency to bruise or bleed, fluid retention, swelling, putting on weight, low sodium in the blood, confusion, headache, double or blurred vision and a dry mouth.
Up to 1 in 100 people have reported: abnormal involuntary movements, tremors, tics, abnormal eye movements, diarrhoea and constipation.
Up to 1 in 1,000 people have reported: disease of the lymph glands, folic acid deficiency, allergic reactions, joint pain, fever, problems with the kidneys, hallucinations, depression, loss of appetite, restlessness, aggression, agitation, confusion, speech disorders, numbness, tingling in the hands and feet, muscle weakness, high blood pressure, dizziness, a flushed face, fatigue, nervousness, low blood pressure, faintness, dizziness, confusion, blurred vision, changes to the heart beat, stomach pain, jaundice and lupus like symptoms.
Up to 1 in 10,000 people have reported: Anaemia, porphyria, meningitis, swelling of the breasts and discharge of milk in both male and females, abnormal thyroid function tests, osteomalacia, osteoporosis, increased blood fat levels, taste disturbances, conjunctivitis, glaucoma, cataracts, hearing disorders, deep vein thrombosis (DVT), lung or breathing problems, severe skin reactions including Stevens-Johnson syndrome (more frequent in patients of Chinese or Thai origin), sore mouth or tongue, liver failure, increased sensitivity of the skin to sunlight, alterations in skin pigmentation, acne, excessive sweating, hair loss, increased hair growth on the body and face, muscle pain, spasms, loss of libido, impotence, kidney failure, blood spots in the urine, increased or decreased desire to pass urine or difficulty in passing urine.
The following symptoms have been reported but there is not enough data to suggest how frequent they are: skin reactions, accompanied by general unwellness, changes in blood results, diarrhoea, abdominal pain, fever, inflammation of the colon, reactivation of herpes virus infection, complete loss of nails, bone fractures, decreased bone density, drowsiness, memory loss and purple or reddish-purple bumps that may be itchy.
If you experience any of the following symptoms you should seek immediate medical attention as it may be a sign of an allergic or other serious reaction: serious skin reactions such as rash, blistering of the lips, eyes or mouth, skin peeling accompanied by fever, mouth ulcers, unexplained bruising or bleeding, sore throat, high temperature, yellowing of skin or the whites of the eyes, swollen ankles, feet or lower legs, confusion, pain in the joints and muscles, a rash across the bridge of the nose and cheeks, problems breathing, fever, abnormalities in blood and liver function tests, bronchospasm with wheezing and coughing, feeling faint, facial swelling, pain in the area near the stomach, dizziness, drowsiness, a decrease in blood pressure and confusion.
Is it safe to take antiepileptics with other medications?
It’s crucial that you inform your doctor of any other treatments you are currently taking, including over the counter and herbal remedies, as these can affect the way in which your medication works, as well as cause dangerous or unwanted side effects. This is even more important if you are taking any of the following: hormone contraceptives, hormone Replacement Therapy (HRT), medications for depression or anxiety, corticosteroids, anticoagulants, antibiotics, antifungals to treat fungal infections, paracetamol, dextropropoxyphene, tramadol, methadone, buprenorphine, other antiepileptics, hypertension medication, antihistamines, diuretics, cimetidine, omeprazole, isotretinoin, metoclopramide, aprepitant, acetazolamide, danazol, gestrinone, theophylline, aminophylline, ciclosporin, tacrolimus, sirolimus, paliperidone, aripiprazole, temsirolimus, cyclophasphamide, lapatinib, mefloquine, drugs to treat HIV, levothyroxine, tadalafil, albendazole, bupropion, St John’s and Vitamin B containing supplements.
Are antiepileptics suitable for everyone?
The following conditions and medications mean some antiepileptics are unsuitable: an allergy to any of its ingredients or to those in a related group of medications called tricyclic antidepressants, heart problems, problems with your bone marrow, porphyria and taken monoamine oxidase inhibitors (MAOIs).
What types of antiepileptics are there?
There are several antiepileptic drug types to choose from, each with their own side effects, risks and benefits. Your symptoms, the part of the brain affected by the condition and the specific risks involved will inform which are best suited to you. Some of the most commonly prescribed AEDs include: sodium valproate, topiramate, ethosuximide, oxcarbazepine, carbamazepine, levetiracetam and lamotrigine.
Are antiepileptics safe to take while pregnant or breastfeeding?
If you are pregnant, planning on becoming pregnant, think you may be pregnant or are breastfeeding, you should tell your doctor before starting treatment.
Can I drink alcohol whilst taking antiepileptics?
You should be aware that these medications can increase alcohol’s effects and the risk of side effects. Speak with your doctor before starting treatment for further advice.
Are there food or drink warnings related to antiepileptics?
The consumption of grapefruit or grapefruit juice can increase the likelihood of side effects occurring, and should therefore be avoided during the entirety of your treatment.
Do antiepileptics affect your ability to drive?
Because side effects with this medication can include dizziness, altered vision and loss of muscle coordination, you should wait to see how it affects you before operating any heavy machinery.
Are antiepileptics available to buy over the counter?
No. Antiepileptics are a prescription-only treatment.
How can I buy antiepileptics online?
Our GPhC-registered clinicians can discuss antiepileptics with you via our online video consultation service. You can book an appointment with them between 9.30am-4.30pm, five days a week. They can also issue referrals to specialists for treatment and fit notes, where appropriate.