Treatment of Epilepsy

Treatment of Epilepsy :

After investigating the causes of the disease, planning proper treatment is essential. Any precipitating situations, which may aggravate the disease, should be avoided. Thus late nights, tension, fasting or excessive physical or mental stress should be avoided. Proper medication taken for a considerable period of time can definitely control the disease.

Main drugs (Conventional drugs) used for Epilepsy are:

Phenobarbitone: (e.g. Gardenal, Beetal)

 Phenytoin: (e.g. Dilantin, Eptoin)

Carbamazepine :(e.g. Zeptol, Tegrital, Carbatol,Zen, Mazetol)

Valproate:(e.g. Encorate, Valparin, Epilex)

As per the new technology, now slow release formulation drugs are available in Carbamazepine and Valproic acid e.gTegrital - CR, Valtec - CR respectively. This helps to maintain adequate blood level all through out the day, by taking drugs only twice a day. The important side effects of antiepileptic drugs are discussed in chapter No. 23.

Depending on the symptoms and the type of epilepsy, the doctor decides the right drug. In the last few years many new researches have been conducted on this disease and new drugs have been developed for effective control of Epilepsy. The new researches can be classified in two major categories: surgery and medicines.

Newer Drugs :

The second generation anti-epileptic drugs, now being used to treat patients not responding to conventional drugs include Gabapentin, Lamotrigine, Vigabatrine, Felbamate, Topiramate.

These drugs have been approved by the F.D.A. (Federal Drug Authority of USA). Though the newer drugs seem to have less side effects, fewer things require to be monitored (Viz. 2% patients on Topiramate develop kidney stone). Long term results of these drugs are not yet available, but they seem to be safe in pregnancy. Hence, there would be very little risk to the newborn. Therefore, in patients not improving or having side effects with main conventional drugs, newer drugs should definitely be tried.

Recently Introduced Drugs :

These third generation drugs viz. Oxcarbazepine, Levitiracetam, Zonisamide have only recently been introduced and therefore, we have little experience with these drugs, but to date they have proved to be beneficial. Their side effectsare minimal and hence they are likely to replace easily the older drugs (e.g. Oxcarbazepine is likely to replace Carbamazepine).