Other Types of Epilepsy Drugs
Reviewed by: HU Medical Review Board | Last reviewed: May 2022 | Last updated: June 2022
Epilepsy is a brain disease that causes people to have seizures. With epilepsy, nerve cells in the brain (neurons) do not work properly. Neurons normally create tiny electrical signals in a highly-regulated rhythm. These signals tell other parts of the brain and body what to do.
During a seizure, neurons create too many electrical signals, too quickly. Some doctors describe this as an electrical storm in the brain.
There are dozens of anti-seizure drugs that may be prescribed for epilepsy. These drugs may be prescribed for many types of seizures, such as:1-4
- Generalized seizures
- Atonic seizures
- Focal seizures
- Lennox-Gastaut syndrome
- Dravet syndrome
- Status epilepticus
How do these anti-seizure drugs work?
Every drug on this page works differently. Many work to control seizures by affecting several chemical processes in the body.
For example, topiramate (Topamax®) works in multiple ways, including blocking sodium and calcium channels, activating GABA, and blocking the enzyme carbonic anhydrase. Zonisamide (Zonegran®) works by blocking both the sodium and calcium channels that allow electrical pulses to enter brain cells. Fenfluramine (Fintepla®) seems to affect NMDA (N-methyl-D-aspartate) and GABA (gamma-aminobutyric acid) transmission in the brain.1,3
There are several drugs that do not fit neatly with other types of anti-seizure medicines. These drugs include:1-4
- Acetazolamide (Diamox®)
- Adrenocorticotropic hormone (ACTH)
- Everolimus (Afinitor®, Zortress®, and Afinitor Disperz®)
- Fenfluramine (Fintepla®)
- Felbamate (Felbatol®)
- Perampanel (Fycompa™)
- Topiramate (Topamax®)
- Topiramate XR (Qudexy® XR, Trokendi XR®)
- Zonisamide (Zonegran®)
Some of these drugs are commonly prescribed. Others are rarely prescribed. Some are often taken alone (monotherapy), and others are given as an add-on medicine when 1 drug does not control seizures.
What are the possible side effects?
Side effects are common with any type of anti-seizure medicine. Side effects can vary depending on the specific drug you are taking. The most common side effects of these drugs include:1-4
- Brain fog, confusion, or problems concentrating
- Kidney stones
- Weight loss
- Changes in eye pressure
- Tremor or problems with coordination
- Mood changes
- Sleepiness or fatigue
- Hair loss
- Heart abnormalities
This is a large group of drugs, and none cause all of these symptoms. Sometimes side effects can be reduced by lowering the dose or switching to a different drug.2
These are not all the possible side effects of these drugs. Talk to your doctor about what to expect when taking these drugs. You also should call your doctor if you have any changes that concern you when taking anti-seizure medicine.
Things to know about anti-seizure medicines
Some of these medications require some monitoring with blood work. Depending on which medication, your doctor will test your blood to monitor things such as liver or kidney function, the electrolytes or salts in your blood, or your blood counts of red blood cells, white blood cells, and platelets. Some seizure drugs can cause problems with how the bone marrow and organs work. Regular blood work helps your doctor monitor for side effects.2
Depending on the drug, you may take these medicines by mouth, injection, or infusion. Some can be taken with other anti-seizure medicines, while others can only be taken alone.2
Some of these drugs should not be taken during pregnancy due to the possibility of birth defects.2
Other types of anti-seizure medicines work on different pathways. These include:1
- Sodium channel blockers
- Calcium channel blockers
- Slowing (inhibitory) transmitters
- SV2A protein binders
Before beginning treatment for epilepsy, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.