An overviewThe majority of epileptic seizures can be successfully treated and controlled by appropriate anti-epileptic drugs (AEDs). AEDs are available in a range of doses and forms, e.g. tablets, liquids and syrups, nasal sprays, injections, and rectal preparations (suppositories), and they are prescribed free of charge.

Almost all AEDs have two names – a generic or basic chemical name, e.g. sodium valproate; and a brand or manufacturer’s name, e.g. Epilim. Brand names are used by the manufacturer that is first licensed to produce and sell drug, and for a certain period of time they are the only company allowed to do so. After this time, other manufacturers can apply for licences to make and sell their own versions of the drug, but they must use the generic name. For many AEDs, it is preferable to stick to whichever version of the drug (generic or brand) is usually prescribed for you and not to switch between the two.

Please don’t hesitate to contact us on 020 8747 5024 or at info@eruk.org.uk if you have any queries or concerns about your AED supply.

Epilepsy specialists aim to tailor drug treatment to suit the needs and medical history of each individual. The aim of treatment is to achieve maximum seizure control, with minimum side effects, on the lowest possible dose of a

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single drug. The majority of people with epilepsy will have their seizures controlled with one AED (this is called monotherapy), although some people will require treatment with two or more drugs (known as polytherapy).

Anti-epileptic drug treatmentIn this leaflet Dr Graeme Sills, a neuropharmacologist in Liverpool, gives an overview about anti-epileptic drugs and their potential side effects.

Stopping AEDs or changing the dose or regime without medical supervision is not advisable and can result in serious problems.

Pill boxes are readily available from your pharmacist to help you manage your medication.

When taking AEDs, it’s important to keep a close record of your seizures, symptoms and any side effects, so that you can discuss these with your doctor at your clinic appointment.

Side effects of AEDsAEDs can produce many unwanted side effects, e.g. tiredness, dizziness, and headache. The information leaflet that accompanies each AED contains a full list of possible side effects and how common they are. If side effects persist, or if you develop a rash in response to an AED, you should inform your doctor immediately.

Dr Graeme Sills

Altered effectiveness of AEDsSome medicines (including over-the-counter remedies) can alter the effectiveness of AEDs; and AEDs can also alter the effectiveness of other medications including the contraceptive pill. You should always check that your GP and community pharmacist know about all of the medications you are taking, including over-the-counter remedies, so that they can try and avoid these problems.Some illnesses, infections and fevers can also affect how AEDs work, and you should ask your GP or pharmacist if you have any concerns about this.

First-line AEDs These are licensed to be prescribed as monotherapy at the start of treatment for the most common types of epilepsy. They may also be used as second-line treatments in other types of epilepsy.

Brand/manufacturer’s name

Generic/chemical name

Epilim, Epilim Chrono sodium valproate

Emeside/Zarontin* ethosuximide

Keppra levetiracetam

Lamictal lamotrigine

Tegretol, Tegretol Retard carbamazepine

Second-line AEDs These are typically prescribed as an addition to an existing first-line drug. Some of them may, under certain circumstances, be prescribed as a first-line treatment or as an alternative monotherapy when first-line AEDs have not been successful.

Brand/manufacturer’s name

Generic/chemical name

Epanutin phenytoin

Frisium clobazam

Fycompa perampanel^

Luminal phenobarbital

Lyrica pregabalin

Neurontin gabapentin

Rivotril clonazepam

Topamax topiramate

Trileptal oxcarbazepine

Vimpat lacosamide^

Zebinix eslicarbazepine acetate^

Zonegran zonisamide

Third-line AEDs These are rarely used; any new prescriptions for these AEDs would only be for very specific types of epilepsy or when all other drugs have been unsuccessful.

Brand/manufacturer’s name

Generic/chemical name

Diacomit stiripentol^

Diamox, Diamox SR acetazolamide

Gabitril tiagabine

Inovelon rufinamide^

Mysoline** primidone

Nootropil piracetam

Sabril vigabatrin

Trobalt retigabine^

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AEDs for treating serial seizures and status epilepticus†

This is one in a series of information leaflets about epilepsy.To access the others, or to find out more about our research, please visit our website: www.epilepsyresearch.org.uk

Text adapted from material supplied by Epilepsy Connections, February 2014.

Brand/manufacturer’s name

Generic/chemical name

Ativan lorazepam

Buccolam, Epistatus midazolam

Valium diazepam

* Emeside and Zarontin brands are only available in syrup form. Other forms of ethosuximide are supplied by generic name only.

** Mysoline brand is no longer available – primidone is supplied by generic name only.

^ There are no generic versions of these drugs yet, because the original manufacturer still holds an exclusive license (or patent) to sell them.

† Status epilepticus is a condition in which seizures persist for 30 minutes or more. It can occur with all types of seizures, but with tonic-clonic seizures it represents a medical emergency requiring immediate treatment.

If a tonic-clonic seizure lasts more than five minutes, or if a second seizure occurs before the person has recovered, call for medical help.

If you have any queries about your AEDs, please don’t hesitate to contact us and we will do our best to help.

Epilepsy Research UK PO Box 3004 London W4 4XTt 020 8747 5024 f 0870 838 1069e info@eruk.org.uk w www.epilepsyresearch.org.uk

Registered office: Lamb House, Church Street, London W4 2PD. Registered charity no: 1100394