Drug Therapy For Seizure Disorder – First Line Aeds For Seizure

Not all types of seizures require medication. Some forms of seizures which are directly associated with such problems as withdrawal from alcohol and certain drugs may be prevented by correcting the underlying problem. With serious forms of seizure, however, like with epileptic seizure, treatment using drug therapy separates a normal brain activity from the next seizure episode.

Seizures are treated using anti-epileptic drugs or AEDs. These, in general, prevent seizures from occurring in the majority of people who take them exactly as prescribed. In 50% of all patients who use AEDs, complete control over their seizures are gained. In 20%, significant reduction in the frequency of seizures has been observed, while 30% of all users of AEDs gain very little benefit from using these drugs.

The first line of AEDs commonly used are as follows:

Phenytoin (includes fosphenytoin and phenytoin sodium)
Usage: Phenytoin is one of the major drugs chosen for treatment of partial seizures and generalized tonic-clonic seizures. This is never used on cases of myoclonic seizures and absence seizures.

Effects: When used properly, this drug can effectively prevent attacks of generalized clonic-tonic seizures and partial seizures.

Side effects: Phenytoin may cause tender and swollen gums, enlarged facial features, skin rash, acne and growth of body and facial hair. High dose of phenytoin in the body may result in drowsiness, tremors and shaking, double vision, dizziness, confusion, decreased ability to concentrate, decreased coordination, and osteoporosis with prolonged use.

Valproic acid (includes divalproex sodium, valproic acid, and valproate sodium)
Usage: This is a drug of choice for generalized epilepsy, myclonic seizures, and absence seizures, and is considered very effective for partial seizures, atonic seizures, complex partial seizures, and generalized tonic-clonic seizures.

Effects: The mechanism behind the efficacy of these drugs is not clear, however, it is understood that these work by increasing a level of a particular chemical in the brain, resulting in reduced seizure activity.

Side effects: Use of valproic acid commonly results in side effects such as nausea, stomach cramps, vomiting, temporary hair loss, shaking and tremors, weight gain and irregularity of menstrual cycle.

Carbamazepin
Usage: Carbamazepin is used by both children and adult patients. It is the medicine of choice for very young patients and is one of three commonly prescribed AEDs for adults.

Effects: These very powerful AED is known to address a wide range of activities that trigger seizure. It is, at the present, the most effective as well as the most powerful drug for seizure control. It works by calming the electrical activities of the brain.

Side effects: In correct dosage, carbamazepine may induce unwanted symptoms like lightheadedness, dryness of the mouth, giddiness, and mild nausea. All these occur during the first few days or use of the drug. Serious side effects are not very common but include such conditions as jaundice and lowering of leukocyte count or white blood cell count, leading to the ulceration of the mouth and the throat.

Other first line AEDs include Ethosuximide for cases of absence seizures only, Topiramate, Oxcarbazepine, Primidone and Phenobarbital.