If you or someone you care for has epilepsy, the good news is there are many treatment options that reduce seizures and improve life. Treatment isn’t one-size-fits-all — it’s a plan you build with a neurologist based on seizure type, age, other health problems, and goals like driving or pregnancy.
First-line care usually starts with antiseizure medications. Common choices include levetiracetam, lamotrigine, carbamazepine, valproate, topiramate and others. Each drug works differently and has distinct side effects. Expect your clinician to try one medication at a time, adjust the dose, and switch if seizures continue or side effects become a problem. Never stop a medication suddenly — that can trigger more seizures.
If seizures keep happening after two appropriate medicines, ask about further options. Epilepsy surgery may remove or disconnect the brain area causing seizures and can be curative for some people. Vagus nerve stimulation (VNS) and responsive neurostimulation (RNS) are devices that reduce seizures when surgery isn’t an option. Dietary therapy, especially the ketogenic diet or modified versions, helps some children and adults. Cannabidiol (prescription CBD) is approved for specific syndromes like Dravet and Lennox–Gastaut and can be discussed with your doctor.
Choosing among these depends on test results — MRI, prolonged EEG, and sometimes video monitoring. Bring a clear seizure history and medication list to appointments; that information steers the decision toward the best next step.
Keep a seizure diary: note date, time, length, what you were doing, triggers, and recovery. This helps your doctor and can reveal patterns. Watch for common triggers: missed meds, poor sleep, alcohol, stress, and flashing lights for some people. Prioritize regular sleep and medication adherence — those two steps alone cut many seizures.
Think safety: if seizures cause loss of awareness, modify the home (remove sharp edges, avoid unsupervised swimming, use gas stoves with caution). Know first-aid: stay with the person, cushion their head, do not force anything into the mouth, and call emergency services if a seizure lasts longer than five minutes, breathing doesn’t return, or repeated seizures occur without recovery.
For women of childbearing age, plan pregnancies with your neurologist. Some antiseizure drugs carry higher birth-defect risks; folic acid and careful drug choice reduce harm. Driving and work rules vary by country — check local laws and discuss risk management with your doctor.
Finally, keep communication open. Ask about side effects, drug interactions (including over-the-counter supplements), and what to expect long term. With the right team and a clear plan, many people with epilepsy lead active, fulfilling lives.
May, 26 2025