Patient_ep_onset.qxd

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.
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