Drugs to treat epilepsy


Epilepsy represents a serious neuronal disorder derived essentially from the alteration of electrical impulses in the brain; in this syndrome, neurons (the cells used for signal transmission) go crazy, causing serious consequences to the patient, who manifests more or less recurrent convulsions.


Epilepsy is heavily influenced by the genetic component, but familiarity is not the sole causal factor; three other etiological elements that are at the origin of epilepsy, include: abuse of alcohol or drugs during pregnancy, abscesses and brain tumors, severe breathing difficulties shortly before birth (anoxia), exanthemia diseases (measles, rubella, varicella), head trauma.


Epileptic seizures, due to neuronal hyperactivity, can induce loss of consciousness; moreover, epilepsy is characterized by: sensory / psychological alteration, temporary mental confusion, uncontrolled gestures of arms and legs, wide-open eyes with empty eyes, slowing down or stopping breathing, muscle stiffness.

Information on Epilepsy - Drugs for the treatment of epilepsy is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Epilepsy - Drugs for the treatment of epilepsy.


Even in its mild forms, epilepsy is considered a risky and dangerous disease, therefore it is good to seek medical attention and request a drug treatment to prevent the symptoms from getting worse or for the seizures to recur; just think, for example, of the danger a patient has in epileptic seizures during sports activities such as swimming or driving.

In the case of overt epilepsy, the doctor generally prescribes antiepileptic drugs: these active ingredients, in most cases, produce extraordinary effects, so as to reduce both the frequency and intensity of epileptic seizures. For some patients, epilepsy manifests itself in such a mild form that the administration of a single drug, for a longer or shorter period of time, is sufficient to cancel the symptoms and avoid the recurrence of the crises.

If the drugs are not entirely beneficial to the patient's health, the specialist may propose surgical treatment or other alternative treatments (vagus nerve stimulation).

The most complex problem seems to be the choice of the most suitable drug for the patient, both in terms of type and dosage; to cope with this problem and to test its possible reliability and effectiveness, the doctor generally prescribes rather low dosages, to increase the dosage from time to time, gradually, until complete control of epileptic seizures.

  • Phenytoin (eg Metinal Idantoin L, Dintoinale, Fenito FN): antiepileptic drug useful for preventing tonic-clonic seizures (violent and abrupt spasms on the muscles, alternating with muscle relaxation). It is recommended to take the drug intravenously at a dose of 10-15 mg / kg for slow injection into a vein (no more than 50 mg per minute). Alternatively, you can inject 15-20 mg of active per kilo of body (not more than 50 mg per minute). The maintenance dose is 100 mg orally or IV every 6-8 hours (do not exceed 50 mg per minute). It is recommended to monitor the plasma concentration of phenytoin, to keep side effects under control.

The drug can modulate facial features, as well as generate acne, hirsutism and gingival hyperplasia; in addition, it gives liver toxicity.

  • Sodium valproate (eg. Depakin, Ac Valproico): the drug is an anticonvulsant used in therapy to treat and prevent seizures in the context of epilepsy. At the beginning, the drug is taken at a dose of 10-15 mg / kg a day; if necessary, increase the dose by 5-10 mg / kg per week, to obtain the maximum therapeutic benefit. Generally, the maintenance dose is 60 mg / kg per day or less. The side effects of the drug are dose related.
  • Topiramate (eg Sincronil, Topamax): this drug is used as a supplement to a primary therapy, especially to treat and prevent generalized tonic-clonic seizures. However, it can also be used as a single agent at an initial dose of 25 mg, taken in the evening, for 7 days. Slowly increase the dosage by 25-50 mg a day, every 7-14 days, always taking the drug in two divided doses over 24 hours. The maintenance dose is expected to take 100 mg of active, in 2 doses (do not exceed 400 mg / day). The drug, in addition to being used for the treatment of epilepsy, is also used to treat severe headaches and to lose weight (anorectic properties).
  • Clobazam (eg. Frisium): the drug belongs to the benzodiazepines and is sometimes used in therapy for epilepsy, with the aim of counteracting tonic-clonic seizures. Do not forget, however, the heavy sedative effects. Benzodiazepine therapy should generally not last for long periods, given the striking side effects of these powerful drugs. It is recommended to administer 20-30 mg of active per day; do not exceed 60 mg per day.
  • Clonazepam (eg Rivotril): in general, this benzodiazepine is used in therapy as a complementary treatment to that with the classic summation therapists. Therefore, it is not the drug of first choice. Take 0.5 mg (for epileptic elderly) or 1 mg (dose for adults with epilepsy), in the evening, for 4 days. It is possible to increase the dosage after 14-28 days, depending on the response to the cure. The maintenance dose is 4-8 mg. Consult your doctor.
  • Ezogabine or Retigabine (eg Trobalt): this drug is suitable in the treatment of partial epilepsy: it is a drug that favors the opening of the neuronal channels of potassium. The dosage must be carefully established by the doctor on the basis of the response to the cure; in general, the dose is 100 mg, to be taken 3 times a day. The dose may increase up to a maximum of 50 mg, three times a day, depending on the clinical response. The maintenance dose varies from 200 to 400 mg, to be taken by mouth, between times a day. Do not exceed 1, 200 mg a day.
  • Lacosamide (eg Vimpat): indicated for the treatment of partial epileptic seizures, for patients over 16 years of age. In general, it is recommended to take 50 mg of the drug, twice a day. After 7 days, increase the dosage to 100 mg twice a day. Possibly, it is possible to increase the dose of 50 mg every week (2 times a day), up to a maximum of 200 mg twice a day.
  • Levetiracetam (eg Keppra): patients with epilepsy with partial seizures with or without generalization, suffering from myoclonic or tonic-clonic seizures can be treated with this antiepileptic drug. Indicatively, the drug should be taken at a dosage of 250 mg twice a day, up to 500 mg, twice a day (after 14 days). After a month, the dose can be increased up to a maximum of 1, 500 mg twice a day. Patients with epilepsy taking another drug should take a different dosage of Keppra. Consult your doctor for any clarifications.

Deepening: diet and epilepsy

It has been observed that a diet rich in lipids and low in carbohydrates (ketogenic diet) is able to reduce epileptic seizures, especially in children who are affected (less than or equal to 10 years): in the context of a state of ketosis in fact, the incidence of epilepsy attacks is significantly reduced.