Epilepsy and Seizure Medications List


 Seizures can occur for a number of reasons, such as injury or sickness.

Epilepsy can also lead to seizures, since it causes your brain to send abnormal signals.

There are several types of epileptic seizures. Many of them can be treated with antiseizure medications.

Medications used to treat epilepsy are called antiepileptic drugs (AEDs). There are more than 30 prescription AEDs on the market, and they’re mostly available as oral tablets or capsules.

Your options depend on:

  • your age
  • your lifestyle
  • your chance of becoming pregnant
  • the types of seizures you have
  • how often you have seizures

There are two types of medications for epilepsy:

  • narrow-spectrum AEDs
  • broad-spectrum AEDs

Some people may need to take more than one medication to prevent seizures.

Narrow-spectrum AEDs are designed for specific types of seizures. These drugs are often used to treat or prevent seizures that occur in a specific part of the brain on a regular basis.

If you have more than one type of seizure, a broad-spectrum AED may be your best choice of treatment. These drugs are designed to treat or prevent seizures in more than one part of the brain.

Seizures are typically divided into three major categories:

  • focal onset
  • generalized onset
  • unknown onset

Focal onset seizures

Focal onset seizures begin in one area of the brain. They were previously called partial seizures.

You may or may not lose consciousness during a focal onset seizure. The former is known as a focal impaired awareness seizure, and the latter is known as a focal awareness seizure.

In focal to bilateral tonic-clonic seizures, the seizure begins in one area of the brain but spreads to involve both areas. You also lose consciousness. This type was previously called secondary onset seizure.

Generalized onset seizures

Generalized onset seizures begin in both areas of the brain. They include:

  • Generalized tonic-clonic seizures. These seizures cause both muscle stiffness and jerking movements. They were previously called grand mal seizures.
  • Absence seizures. These seizures last for no more than 20 seconds and cause symptoms that signal a lapse in awareness, such as blank staring. They’re more common in kids and teens and were previously called petit mal seizures.
  • Myoclonic seizures. Myoclonic seizures cause jerking movements that last for just 1 or 2 seconds.

Unknown onset seizures

If it can’t be determined where the seizure started, it’s categorized as an unknown onset seizure.

Narrow-spectrum AEDs are primarily used to treat focal seizures. The Food and Drug Administration (FDA) has approved the following narrow-spectrum AEDs for the treatment of seizures or epilepsy:

Carbamazepine (Carbatrol, Tegretol, Epitol, Equetro)

Carbamazepine (Carbatrol, Tegretol, Epitol, Equetro) is used to treat focal seizures, including ones that occur in the temporal lobe. This medication may also help treat:

  • generalized tonic-clonic seizures
  • refractory epilepsy, which is resistant to treatment
  • mixed seizure types, which are a combination of focal and generalized seizures

It’s available as a pill and as an oral suspension.

Carbamazepine interacts with many other medications. If you’re prescribed carbamazepine, make sure to tell your doctor about all of the medications you’re taking.

Eslicarbazepine (Aptiom)

Eslicarbazepine (Aptiom) is used to treat focal seizures, including focal to bilateral tonic-clonic seizures.

It’s thought to work by blocking sodium channels. Doing this slows the nerve firing sequence in seizures.

Ethosuximide (Zarontin)

Ethosuximide (Zarontin) is used to treat all forms of absence seizures. These include:

  • atypical absence seizures
  • childhood absence seizures, which usually begin at 4 to 8 years old
  • juvenile absence seizures, which usually begin at 10 to 16 years old

It’s available as a pill and as an oral syrup.

It works in part by increasing the seizure threshold, making it more difficult for your brain to start a seizure.

Everolimus (Afinitor, Afinitor Disperz)

Everolimus (Afinitor, Afinitor Disperz) is used to treat focal seizures caused by tuberous sclerosis, a rare genetic disorder that leads to benign tumors.

It’s available as a pill and as an oral suspension.

It can be prescribed to people as young as 2 years old.

Gabapentin (Neurontin)

Gabapentin (Neurontin) is used to treat focal seizures.

It’s available as an oral tablet, capsule, and suspension.

Gabapentin’s side effects may be milder than the side effects of other AEDs. Common side effects include dizziness and fatigue.

Lacosamide (Vimpat)

Lacosamide (Vimpat) is used to treat focal seizures, including focal to bilateral tonic-clonic seizures and ones that begin in the temporal lobe.

It’s available as a pill, an oral solution, and an intravenous (IV) solution. The IV solution is only administered by a healthcare professional.

Oxcarbazepine (Trileptal, Oxtellar XR)

Oxcarbazepine (Trileptal, Oxtellar XR) is used to treat generalized tonic-clonic seizures as well as all types of focal seizures.

It’s available as a pill and as an oral suspension.

It can be prescribed to people as young as 2 years old.

Phenobarbital

Phenobarbital is the oldest seizure medication available today. It’s used to treat:

  • some focal seizures
  • some generalized seizures
  • refractory epilepsy

It’s not recommended for absence seizures.

It’s available as a pill and as an oral solution.

Phenobarbital is a long-acting sedative with anticonvulsant action. Sedatives may make you feel very drowsy.

Phenytoin (Dilantin, Phenytek)

Phenytoin (Dilantin, Phenytek) is another older, commonly used medication.

Like phenobarbital, it’s also used to treat some focal seizures (such as temporal lobe seizures), some generalized seizures, and refractory epilepsy. It’s not recommended for absence seizures.

It’s available as:

  • a pill
  • an IV solution
  • an oral solution
  • an injection

Phenytoin stabilizes membranes in the neurons. This action calms nerve firings in your brain.

Pregabalin (Lyrica)

Pregabalin (Lyrica) is used as an add-on treatment for focal impaired awareness seizures and focal awareness seizures. This means you’ll take it with other seizure medications.

It’s available as a pill and as an oral solution.

It can be prescribed to people as young as 1 month old.

Tiagabine (Gabitril)

Tiagabine (Gabitril) is used as an add-on treatment for focal impaired awareness seizures and focal awareness seizures.

In the United States, it’s only available as a brand-name medication.

One benefit of tiagabine is that it causes relatively few side effects.

Vigabatrin (Sabril)

Vigabatrin (Sabril) is used as an add-on treatment for focal impaired awareness seizures that haven’t responded to other medications.

It’s available as a pill and an oral solution.

Due to serious side effects such as permanent vision loss, the use of this medication is restricted. Only doctors and pharmacies that are registered with a special program can prescribe and dispense this medication.

The FDA has approved the following broad-spectrum AEDs for the treatment of seizures or epilepsy:

Acetazolamide

Acetazolamide is used as an add-on treatment for seizures that begin near the center of the brain, which includes some absence seizures.

It’s available as a pill and an injection. In the United States, it’s only available as a generic medication.

The brand-name version, known as Diamox, has been discontinued.

Brivaracetam (Briviact)

Brivaracetam (Briviact) is used to treat focal seizures.

It’s available as a pill, an oral solution, and an IV solution.

The FDA approved this medication in June 2020, making it one of the newest seizure medications on the market.

Cannabidiol (Epidiolex)

Cannabidiol (Epidiolex) is used to treat seizures caused by:

  • tuberous sclerosis
  • Dravet syndrome
  • Lennox-Gastaut syndrome

Dravet syndrome is a rare type of treatment-resistant epilepsy that causes prolonged seizures. It usually affects young children.

Lennox-Gastaut syndrome is a severe form of epilepsy that typically begins during childhood. It can cause many types of seizures, including atypical absence seizures.

Epidiolex is available as an oral solution. In the United States, it’s only available as a brand-name medication.

Epidiolex is the only FDA-approved product that contains cannabidiol, also known as CBD.

Cenobamate (Xcopri)

Cenobamate (Xcopri) is used to treat focal seizures in adults.

It’s one of the newer FDA treatments for seizures, having been approved in November 2019. It’s also one of the most effective, at least in clinical trials, according to commentary published in the journal Epilepsy Currents.

Clobazam (Onfi, Sympazan)

Clobazam (Onfi, Sympazan) is used to treat seizures caused by Lennox-Gastaut syndrome.

It’s available as a pill, an oral suspension, and an oral film.

Like many broad-spectrum AEDs, it belongs to a class of medications called benzodiazepines. These medications are often used for:

  • sedation
  • sleep
  • anxiety

In rare cases, clobazam may cause a serious skin reaction.

Clonazepam (Klonopin)

Clonazepam (Klonopin) is a long-acting benzodiazepine. It’s used to treat many types of seizures, including:

  • myoclonic seizures
  • absence seizures
  • atonic seizures

Atonic seizures cause a loss of muscle tone and may begin in one or both areas of the brain.

Clonazepam is also a well-known treatment for panic disorder.

Clorazepate (Gen-Xene, Tranxene-T)

Clorazepate (Gen-Xene, Tranxene-T) is also a benzodiazepine. It’s used as an add-on treatment for focal seizures.

It’s also used to treat conditions such as alcohol withdrawal syndrome.

Diazepam (Valium, Valtoco, Diastat)

Diazepam (Valium, Valtoco, Diastat) is used to treat clusters of seizures as well as prolonged seizures. This medication is also a benzodiazepine.

It’s available in multiple forms, including pills, a rectal gel, and a nasal spray.

Diazepam is a rescue medication that’s often used to relieve symptoms in an emergency. It’s rarely taken as a daily medication.

Divalproex (Depakote, Depakote ER)

Divalproex (Depakote, Depakote ER) is used to treat:

  • focal impaired awareness seizures
  • absence seizures
  • mixed seizure types

Divalproex increases availability of gamma aminobutyric acid (GABA). GABA is an inhibitory neurotransmitter, which means it slows down the nerve circuits. This effect helps control seizures.

Felbamate (Felbatol)

Felbamate (Felbatol) is used to treat nearly all types of seizures in people who don’t respond to other treatment.

It can be used as a standalone therapy or an add-on treatment. It’s prescribed only after many other treatments haven’t worked.

It’s available as a pill and as an oral suspension.

Serious side effects include anemia and liver failure.

Fenfluramine (Fintepla)

Fenfluramine (Fintepla) is used to treat seizures caused by Dravet syndrome.

It’s only available as an oral solution.

In June 2020, the FDA approved this medication for the treatment of seizures. Fenfluramine had previously been used, along with phentermine, in the controversial weight-loss drug Fen-Phen.

Lamotrigine (Lamictal, Lamictal CD, Lamictal ODT, Lamictal XR)

Lamotrigine (Lamictal, Lamictal CD, Lamictal ODT, Lamictal XR) may treat a range of epileptic seizures, including:

  • focal seizures
  • generalized tonic-clonic seizures
  • generalized seizures caused by Lennox-Gastaut syndrome

The United Kingdom’s Commission on Human Medicines declared it one of the safest epilepsy medications to take during pregnancy.

However, people who take this medication must watch for a rare and serious skin condition called Stevens-Johnson syndrome. Symptoms can include shedding of your skin.

Levetiracetam (Elepsia XR, Keppra, Keppra XR, Spritam)

Levetiracetam (Elepsia XR, Keppra, Keppra XR, Spritam) may treat a range of epileptic seizures, including:

  • focal seizures
  • generalized tonic-clonic seizures
  • myoclonic seizures
  • juvenile myoclonic seizures

It’s available as a pill, an IV solution, an oral solution, and an injection.

Levetiracetam may cause fewer side effects than other medications used for epilepsy. It’s safe to take during pregnancy, according to experts such as the United Kingdom’s Commission on Human Medicines.

Lorazepam (Ativan)

Lorazepam (Ativan) is a benzodiazepine that’s used to treat all types of seizures. It’s also used to treat status epilepticus. Status epilepcticus is a prolonged, critical seizure that’s regarded as a medical emergency.

It’s available as a pill, an oral concentrate, and an injection.

Methsuximide (Celontin)

Methsuximide (Celontin) is used for absence seizures. It’s prescribed when other treatments don’t work in treating your seizures.

Methsuximide slows down your brain’s motor cortex, which slows down your movements. It also increases the seizure threshold.

Perampanel (Fycompa)

Perampanel (Fycompa) is used to treat:

  • focal seizures
  • generalized seizures
  • refractory epilepsy

It’s available as a pill and an oral suspension.

It isn’t fully understood how this medication works. It may affect glutamate receptors in your brain.

Perampanel can cause life threatening psychiatric or behavioral side effects. Talk with your doctor to learn more.

Primidone (Mysoline)

Primidone (Mysoline) is used to treat focal seizures and generalized tonic-clonic seizures, including treatment-resistant generalized tonic-clonic seizures.

It’s very effective but rarely used, due to concerns about its side effects.

Rufinamide (Banzel)

Rufinamide (Banzel) is used as an add-on treatment for seizures caused by Lennox-Gastaut syndrome.

It’s available as a tablet and an oral suspension.

This medication may cause changes in your heart rhythm. It can also interact with many other medications. For these reasons, it isn’t used often.

Stiripentol (Diacomit)

Stiripentol (Diacomit) is used to treat seizures caused by Dravet syndrome.

It’s available as a pill and as an oral suspension.

It must be administered along with clobazam.

Topiramate (Topamax, Qudexy XR, Trokendi XR)

Topiramate (Topamax, Qudexy XR, Trokendi XR) is used to treat all types of seizures in adults and children.

In the United States, it’s only available as a brand-name medication.

Valproic acid

Valproic acid is a common broad-spectrum AED that’s approved to treat most seizures. It’s closely related to divalproex.

Valproic acid is available as a pill and as an oral syrup. In the United States, it’s only available as a generic medication. All of the brand-name versions have been discontinued.

Valproic acid increases the availability of the neurotransmitter GABA. More GABA helps calm random nerve firings in seizures.

Zonisamide (Zonegran)

Zonisamide (Zonegran) is used as an add-on treatment for focal seizures in adults.

Serious side effects are rare, but they may include cognitive problems, weight loss, and kidney stones.

In 2018, the American Academy of Neurology (AAN) published updated guidelines on the use of newer AEDs.

Part One of the guidelines focused on the treatment of new onset epilepsy, while Part Two focused on treatment-resistant epilepsy.

According to the guidelines, there’s strong evidence (Level A) to support the following recommendations:

  • perampanel and immediate-release pregabalin for use in treatment-resistant adult focal epilepsy (TRAFE)
  • rufinamide and vigabatrin for use in TRAFE, but not as first-line treatments
  • rufinamide as an add-on treatment for people with Lennox-Gastaut syndrome

There’s moderate evidence (Level B) to recommend:

  • clobazam as an add-on treatment for people with Lennox-Gastaut syndrome
  • eslicarbazepine for the treatment of TRAFE
  • ethosuximide instead of lamotrigine for absence seizures in children, unless there are concerns about negative events
  • lacosamide for the treatment of TRAFE
  • lamotrigine
    • for new-onset focal epilepsy in adults
    • for unclassified generalized tonic-clonic seizures in adults
    • as an add-on treatment for adults with treatment-resistant generalized tonic-clonic seizures
  • levetiracetam, as add-on treatments for:
    • treatment-resistant generalized tonic-clonic seizures
    • treatment-resistant juvenile myoclonic epilepsy
    • treatment-resistant focal epilepsy in people 1 month to 16 years old
  • oxcarbazepine as an add-on treatment for treatment-resistant focal epilepsy in people 1 month to 4 years old
  • extended-release topiramate for the treatment of TRAFE
  • valproic acid instead of lamotrigine for absence seizures in children, unless there are concerns about negative events
  • zonisamide as an add-on treatment for treatment-resistant focal epilepsy in people 6 to 17 years old

Before taking an AED, consult your doctor about the side effects it can cause. Some AEDs may make seizures worse in some people.

Use this article as a starting point to ask your doctor for more information. Working with your doctor is helpful in choosing the medication that’s best for you.

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