Understanding Epilepsy Medications

Antiepileptic drugs (AEDs) aim to control seizures. They balance excitatory and inhibitory signals in the brain, but don't cure epilepsy. Treatment is tailored to seizure type, and it's important to maintain therapeutic drug levels.

Common AEDs include Valproate, Carbamazepine, and Levetiracetam. Valproate is often used for generalized seizures, Carbamazepine for focal seizures, and Levetiracetam offers broad-spectrum use with fewer drug interactions.

Some AEDs, like Topiramate and Phenobarbital, can impair cognitive function. This underscores the importance of personalized medication plans and the potential need for regular cognitive assessments during treatment.

Certain AEDs can lead to unique side effects. For example, Lamotrigine may cause a life-threatening rash, while Felbamate carries a risk of aplastic anemia and liver failure, reserved for severe refractory epilepsy.

Long-term AED use can cause nutritional deficiencies. Drugs like Phenytoin, Phenobarbital, and Carbamazepine can decrease levels of Vitamin D, B12, and folic acid, making supplementation necessary.

Pregnancy requires careful AED management due to teratogenic risks. Valproate has a high risk for fetal malformations and cognitive effects, whereas newer AEDs like Lamotrigine are considered safer options during pregnancy.

Newer AEDs focus on improved safety profiles and fewer side effects. Drugs such as Lacosamide and Brivaracetam show promise for more efficient seizure control with less impact on patients' daily functioning.