When to use anti-seizure medication

Anti-seizure medication is used in patients with epilepsy to prevent seizures. Epilepsy is a significant condition, and although it is found in approximately 1% of the Thai population or about 600,000 people nationwide, it can occur at any age, from newborns to the elderly. Reports show that each year, new patients with epilepsy under the age of 20 comprise up to 70%.

It is necessary to start anti-seizure medication when a seizure occurs or not.

If a seizure has been diagnosed by examining the brain's electrical activity and diagnosed by a physician as epilepsy, it is necessary to start anti-seizure medication. Seizures can also occur for other reasons, with fever-induced seizures being common in children. These seizures are called febrile seizures. If the fever is reduced, the seizures will stop, so medication used will typically be for fever reduction, and frequent wiping with a wet cloth can also help reduce fever. Physicians may prescribe anti-seizure medication for some children with febrile seizures, but the medication is only used during the time the child has a seizure and is not required continuously throughout their life.

Therefore, if you ask whether anti-seizure medication needs to be used every time a seizure occurs, it depends on the physician's diagnosis. Typically, the physician will consider the benefits of seizure control when deciding whether to start anti-seizure medication. If there is a high risk of severe side effects from the medication, it will not be used. However, if the patient does not receive medication and continues to have seizures, there is a risk of harm from the seizures and it can affect the patient's quality of life. In such cases, it is necessary to use the medication.

In cases where it is necessary, medication is used when a patient has a seizure without any known cause or trigger, or when the patient experiences more than two seizures due to fever, or when further diagnosis through electroencephalogram (EEG) shows the presence of seizure activity. In such cases, medication may be necessary.

"Patients with epilepsy must have regularity in taking medication, not forget or increase the dosage on their own. Measuring and dividing medication must be precise, as anti-seizure medication is a dangerous drug that affects the brain. If abnormal symptoms occur from taking the medication, medical consultation should be sought immediately."

What are the types of anti-seizure medications and how do they work?

Anti-seizure medications can be classified into two groups: standard and new generation. Examples of standard anti-seizure medications are carbamazepine, phenytoin, phenobarbital, and sodium valproate, while examples of new generation anti-seizure medications include topiramate, levetiracetam, vigabatrin, and lamotrigine. These medications come in various forms such as tablets, capsules, and injections.

Every medication has a mechanism of action that targets the brain areas that release seizure-causing electrical activity, preventing seizures. However, different types of medication are suited for different types of seizures, and doctors will choose the appropriate medication based on the type of seizure that is occurring. For example, medications may target seizures that are specific to certain areas of the brain or those that spread throughout the brain. Seizures may also be categorized as rigid, jerking, or a combination of both, or may be mild or severe.

Therefore, patients or caregivers should provide accurate information to the doctor in order for the doctor to choose the appropriate medication. Typically, doctors will start with one type of medication and use the smallest effective dose to control seizures. If seizures cannot be controlled, the doctor may consider a medication that has been effective and has the fewest side effects to allow the patient to live a normal life.

Most patients need to take anti-seizure medication for about two years or more to reduce the likelihood of recurrent seizures. If there are no seizures, the doctor may gradually reduce the medication until it is stopped. The process of reducing medication may take about 6-12 months. After that, the doctor will schedule follow-up appointments to monitor the patient and prevent seizure recurrence.

Source: Health Today Magazine.