Epilepsy Treatment: What You Need to Know

Epilepsy is one of the most common neurological disorders, affecting approximately 50 million people worldwide each year. However, with proper diagnosis and advancements in epilepsy treatment, around 7 out of 10 people with epilepsy can live a normal, seizure-free life. (1)

Although there is no complete cure for epilepsy, several treatment options can help control seizures, allowing patients to live a seizure-free life. Epilepsy treatments include: (1)

Anti-Seizure Medications (ASMs)

The first-line treatment for epilepsy is anti-seizure medications (ASMs), which must be prescribed by a doctor. Finding the right medication and dosage may require trial and adjustment, as the doctor aims to control seizures effectively while minimizing side effects. (1)

Tips for Using Anti-Seizure Medications

Here are some important guidelines and general information for taking anti-seizure medications: (3)

• Follow your doctor’s instructions carefully regarding dosage and timing, even if you don’t see immediate improvement. Seizure control takes time and may require trying different medications.
• Inform your doctor about all medications and supplements you are taking. Do not start any new medications or supplements without consulting your doctor, as some may interact with epilepsy drugs.
• Report any side effects—whether new or ongoing—to your doctor. Also, let your doctor know if there are any changes in seizure frequency or severity, so they can adjust your medication if needed.
• Never skip doses or stop medication abruptly without consulting your doctor, as this can worsen seizures.
• If you miss a dose, inform your doctor. Do not double the next dose to compensate—continue taking the medication at the usual schedule.
• For women: Inform your doctor if you are pregnant or planning pregnancy to receive pregnancy-safe medication.
• Maintain a healthy lifestyle for optimal medication effectiveness, including adequate sleep, stress management, a balanced diet, exercise, and avoiding smoking.
• Never stop your medication suddenly—sudden changes can trigger seizures.
• Keep up with regular blood tests as recommended by your doctor to monitor drug levels and check for potential side effects.

Can Anti-Seizure Medications Be Stopped?

Discontinuing epilepsy medication should never be done randomly—it requires close medical supervision and a thorough patient evaluation. Depending on the severity of epilepsy, seizure control, and overall health, a doctor may recommend gradually reducing or stopping medication in certain cases. However, some patients may need to take medication for life. (1)

Medication withdrawal is only done gradually and under medical supervision in the following cases: (4)

• Seizure-free for at least two years while on medication.
• Treatment of the underlying cause of epilepsy, such as brain injury recovery.
• Childhood epilepsy that resolves with age.

Other Epilepsy Treatments

Doctors may recommend additional treatments to support medication therapy or use alternative approaches if medications fail to control seizures. These include: (5)

1. Ketogenic Diet

Doctors may recommend a ketogenic (keto) diet, particularly for children with drug-resistant epilepsy. This diet involves significantly reducing carbohydrate intake and increasing healthy fats.

⚠ Do not start the keto diet on your own—it must be done under medical supervision, as it may interact with some epilepsy medications.

2. Epilepsy Surgery

Surgical intervention may be an option when other treatments fail, especially if seizures originate from a specific area in the brain. Surgical options include:

• Removing the brain region responsible for seizures.
• Disrupting nerve pathways involved in seizure activity.

3. Neurostimulation Therapy

Neurostimulation therapy is a promising treatment for drug-resistant epilepsy—patients who do not respond well to medication or surgery. This treatment involves implanting a small electrical device that delivers regular electrical pulses to the brain region responsible for seizures, helping to reduce their occurrence. (3)

References

• Epilepsy, WHO
• Seizure Medication List, Epilepsy Foundation
• Epilepsy - Treatment, NHS
• Epilepsy Treatment: Stages, Types, Medications, and Drug Side Effects, WebMD
• Epilepsy - Diagnosis and Treatment, Mayo Clinic