AAN Guideline Summary for PATIENTS and THEIR FAMILIES EFFICACY AND TOLERABILITY OF THE NEW ANTIEPILEPTIC DRUGS FOR TREATMENT OF NEW ONSET EPILEPSY
If you are someone with newly diagnosed epilepsy, this fact sheet will help you and your doctor talk about medicines— called antiepileptic drugs or AEDs—that help manage, or could possibly end seizures. Recent studies suggest that the new AEDs can also improve your quality of life by minimizing side effects.
About two thirds of people with epilepsy will become seizure free with the first or second drug they try. Most peoplewith epilepsy will stay on the drug prescribed for several years. What are seizures?
The experts decided to look carefully at all the currently
Seizures happen when there are sudden changes in the
available information on the new antiepileptic drugs.
way normal brain cells interact electrically. During a
These experts wanted to find out how safe and effective
seizure, a sudden wave of electrical energy swamps part
the new drugs are in the treatment of children and adults
or all of the brain, disrupting normal brain activity.
with newly diagnosed epilepsy. In some cases, there was
Consciousness, movement, sensation, speech, mood,
not enough information to decide one way or another.
memory, and emotions can all be affected during the oneor two minutes that the seizure lasts.
What do the guidelines say? The experts who studied the data found that there is What are antiepileptic drugs—or AEDs—and how
evidence that four newer antiepileptic drugs are safe and
can they help?
effective for patients with newly diagnosed epilepsy. The
Antiepileptic drugs are chemical compounds that affect
four new drugs that work for newly diagnosed epilepsy
the brain. There are more than 20 drugs used in the
are known in their generic form* as gabapentin, lamotrigine,
treatment of epilepsy. Antiepileptic drugs do not cure the
oxcarbazepine, and topiramate. The experts recommend
condition but will often control seizures completely if the
that these four medications be considered as monotherapy
AEDs are taken regularly. Some AEDs prevent seizures by
—taking one drug at a time—for newly diagnosed
controlling electrical signals in the brain.
adolescents and adults with either partial or mixed seizures. Many of the older antiepileptic drugs are also good
If you have epilepsy, your physician will choose an AED
options for this kind of seizure, but the experts did not
based upon your seizure type, your age, and potential side
effects. People differ in the way that their bodies handledrugs. There is often a trial and error period to determine
The drug known as lamotrigine may also be an option for
the best course of therapy for each individual patient.
children with newly diagnosed absence seizures (alsoknown as petit mal seizures). Many of the older antiepileptic
Why did the experts decide to develop new
drugs are good options for this kind of seizure, but the
guidelines for use of these drugs?
experts did not study the data on these.
Many widely used antiepileptic drugs have been availablefor twenty, thirty, and even more than fifty years. Their
If you have questions about whether you—or your child
positive and negative effects have been widely studied.
—are candidates for these medications, ask your neurologist
However, physicians do not know as much about the
newer antiepileptic drugs that have been approved by theU.S. Food and Drug Administration over the past ten years.
Even if the experts did not find enough information torecommend the use of one of the drugs, your doctor may
Neurologists from the American Academy of Neurology
recommend the AED. The risks, benefits, and options for
(AAN) who specialize in diseases of the brain and central
treatment should be discussed with your doctor.
nervous system, including epilepsy, and experts in epilepsyfrom the American Epilepsy Society (AES), believe youshould know about the options for treating and managingyour epilepsy. *Glossary of generic to name brand drugs What should you know about AED side effects? Name Brand
Some of the side effects are short term, others continue
as long as the medication is taken. Some side effects may
be linked to dosage—the higher the dose needed to control
seizures, the greater the risk of side effects. Side effectsfor each AED are different, and most will go away when
the medication is stopped. The newer antiepileptic drugs
are generally safer than some of the older AEDs. You
should ask your doctor if there are any serious side
AEDs may affect women with epilepsy in their reproductiveyears. Some of the seizure medications available can
How will these recommendations affect
decrease the effectiveness of hormone contraception and
quality of life?
some seizure medications can increase the risk of birth
These drugs often enhance the quality of life for people
defects. However, generally the newer AEDs are thought
with epilepsy. Antiepileptic drugs can make seizures less
to be safer in pregnancy than some of the older AEDs. If
frequent or they can help people with epilepsy lead a
you are a woman with epilepsy of childbearing age, ask
your doctor before you become pregnant about any safetymeasures you should consider to minimize risks to the
The newer AEDs give people with epilepsy the option to
possibly experience fewer side effects. While all medicationshave some side effects, the choice of which drug and
Talk to your neurologist
which side effects can be tolerated depends on the
Together you and your doctor can determine which of
individual person. Your doctor should discuss serious side
the many antiepileptic drugs now available will be the
effects, if any, when starting any of the new antiepileptic
safest and most tolerable. Thanks to the new AAN and AES
drugs. It is important to discuss possible side effects with
guidelines, you and your doctor have more information
your doctor and how willing you are to tolerate these
It is important that your doctor check your progress atregular visits, especially during the first few months ofyour treatment with antiepileptic drugs. This will allowyour doctor to adjust your dose, if necessary, and willhelp reduce any unwanted side effects.
For further information about epilepsy and its treatment, call 1-800-332-1000 or visit www.epilepsyfoundation.org.
This is an evidence-based educational service of the American Academy of Neurology. It is designed to provide members with evidence-basedguideline recommendations to assist with decision-making in patient care. It is based on an assessment of current scientific and clinical information,and is not intended to exclude any reasonable alternative methodologies. The AAN and AES recognize that specific patient care decisions are theprerogative of the patient and the physician caring for the patient, based on the circumstances involved. Physicians are encouraged to carefullyreview the full AAN and AES guidelines so they understand all recommendations associated with care of these patients. 342 North Main Street • West Hartford, CT 06117 1080 Montreal Avenue • St. Paul, MN 55116 www.aesnet.org www.aan.com • www.thebrainmatters.org (860) 586-7505 (651) 695-1940
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