Drug treatment of epilepsy: effective drugs and medications

Many people have heard about epilepsy, but not everyone understands what kind of disease it is, why it occurs and how it progresses. In most cases, we imagine an epileptic attack when a person convulses and foam comes out of his mouth. However, such phenomena are only a small part of the possible options for the development of the disease, because there are many manifestations of such a pathological condition. Many patients can live without seizures at all, as long as they take their epilepsy medication promptly and undergo regular testing.

This disease has been known for a long time. Epilepsy is perhaps one of the oldest forms of brain diseases, which was recognized and tried to be treated with traditional methods hundreds of years ago. For a long time, people suffering from this pathology preferred to hide their diagnosis. This often happens today.

What it is

People have been familiar with epilepsy for a long time: even the ancient Greek healers associated epileptic seizures with the world of the gods and believed that this illness was sent to them because of the unworthy way of their existence. In 400 BC, the outstanding ancient Greek physician and philosopher Hippocrates described this phenomenon. He believed that the cause of epileptic seizures was natural conditions that could provoke liquefaction of the brain.

In the Middle Ages, this disease was feared, believing that it was transmitted from a patient during an epileptic seizure. Meanwhile, they were in awe of her, since many saints and prophets suffered from such an illness.

Modern medicine has proven that epilepsy is a chronic brain disease, characterized by regularly recurring seizures. This is a very common disease, affecting about 50 million people worldwide, which is approximately 1% of the total population of the planet.

How does the disease appear?

Many patients wonder what caused the onset of the disease, because this is a dangerous condition and requires mandatory medical supervision. Medicine identifies three main groups of factors that can lead to the development of the disease:

• Idiopathic (genetic predisposition). Even after tens of generations, the disease can be transmitted. In this case, there are no organic defects or damage in the brain, but there is a certain reaction of neurons. With this form of pathology, an epileptic attack can begin without a reason.
• Symptomatic. The disease can appear after injury, intoxication or tumor processes in the brain. This form of epilepsy occurs spontaneously, and a seizure can occur unpredictably.
• Cryptogenic. A little-studied factor, the exact cause of which has not yet been established. A seizure can occur due to any psycho-emotional stimulus.

The disease can appear at any age, however, according to statistics, epilepsy is more common in young children, adolescents and adults over 60 years of age. To date, medicine has identified about 40 different types of epilepsy. Therefore, the treating doctor must carry out an accurate diagnosis to establish the form of the disease and determine the nature of the seizures. The effectiveness of the results in certain cases depends entirely on the adequacy of the choice of antiepileptic drug and the prescription of the treatment regimen. If treatment is untimely or inadequate, the patient may die. Therefore, a full examination of the patient and an accurate diagnosis of the disease are necessary.

A spontaneous attack can occur due to hormonal changes in the body, alcohol intoxication, or the appearance of flickering and flashing images while driving a car.

What medications are taken for major and minor epileptic seizures?

A major seizure is accompanied by a noticeable loss of consciousness, a fall of the patient, and convulsions.

With minor seizures, the loss of consciousness can be momentary, even imperceptible to others, but the patient clearly feels a clouding of consciousness and subsequently sometimes loses some of his memories: he does not remember the names of his relatives, where he lives, etc.

For rare seizures, sodium borate is prescribed, for frequent and large ones - Phenobarbital.

Major seizures are well relieved and prevented by Diphenin, minor seizures by Trimethine. Both drugs are available in pharmacies with a prescription, the dose is determined by the doctor.

In conclusion, I would like to say that the new generation of drugs (group 2, which we have already discussed) can effectively act on both short-term and severe attacks.

You just need to be prepared for them and not lose touch with doctors.

Examinations and treatment

If epilepsy is suspected, the patient is thoroughly examined. First of all, the patient is examined by a neurologist and studies the history of the disease, including family history. The patient is prescribed the following tests:

• blood;
• fundus;
• X-ray of the skull;
• Dopplerographic study of cerebral arteries.

It is mandatory to visualize the structure, functions and biochemical characteristics of the brain using X-ray, computed tomography or magnetic resonance imaging (MRI). Hours of electroencephalography (EEG) are of great importance in diagnosing the disease.

Such laboratory studies are aimed at determining the true causes of the disease and excluding pathologies that can cause seizures, but are not associated with brain diseases.

The main effect on epilepsy is medications. The result of medical care in the treatment of pathology depends both on the correct selection of medications and on the patient’s compliance with all doctor’s recommendations. The principle of medical intervention is an individual approach to each patient, continuity and duration of treatment. Antiepileptic therapy will be effective if:

• early onset of exposure to the manifestation of characteristic symptoms with antiepileptic drugs;
• desire for monotherapy;
• the correct choice of medication for epilepsy, depending on the type of attacks of a particular patient;
• if necessary, introduction of a rational combination of polytherapy (if there is no effect from the use of one drug);
• prescribing appropriate medications in dosages that provide complete therapy;
• taking into account the pharmacokinetic and pharmacodynamic properties of prescribed drugs;
• monitoring the presence of antiepileptic drugs in the patient’s body.

Epilepsy medications cannot be stopped at once. They should be taken until complete relief from pathological manifestations is obtained. Only in cases of individual intolerance to the components of the drug, allergies, or in the event of side effects, gradual withdrawal of the drug is necessary. Doses of drugs for the treatment of epilepsy are gradually reduced. If the doctor decides that the therapy does not bring the desired result, then new medications are also gradually introduced.

It has been proven that almost all patients newly diagnosed with epilepsy can completely control the occurrence of seizures with the help of antiepileptic drugs. After 2-5 years of full treatment, most patients can stop treatment without the risk of relapse.

Sleeping pills and sedatives

Since epilepsy is a disease of increased excitability, the components of this group are prescribed without fail.

Moreover, they do not always have a high cost, but they are always effective.

Valerian for epilepsy:

• Available over-the-counter in the form of tablets and tinctures;
• has a depressing effect on the nervous system;
• relaxes muscle tension;
• slows down the heart rate;
• take 3-4 tablets or 30-40 ml 3 times a day;
• Contraindicated in case of fructose intolerance.

Phenazepam for epilepsy:

• prescription;
• Available in tablet form;
• single dosage – from 0.5 mg to 7-9 mg in difficult cases;
• quickly becomes addictive;
• side effects: urinary incontinence, dizziness;
• Contraindicated for glaucoma and alcohol poisoning.

Afobazole for epilepsy:

• available without a prescription in tablet form;
• has a mild effect;
• the daily dose should not exceed 30 mg, taken 3 times a day;
• Side effects include dry mouth and dizziness;
• compatible with alcohol, but for epilepsy this combination, like alcohol in general, is not recommended;

What injection is given for epilepsy? Relanium for epilepsy:

• prescription; Available in the form of ampoules for intramuscular or intravenous administration;
• the main side effects are drowsiness, dizziness;
• perfectly relieves feelings of anxiety, as the beginning of increased arousal;
• Contraindications – acute respiratory failure, pregnancy, allergic reactions.

Tenoten for epilepsy:

• available in tablet form without a prescription;
• daily dose: 1 tablet 2 times a day, regardless of meals;
• Contraindications include intolerance and hypersensitivity to lactose.

Drug groups

Achieving optimal results in the treatment of epilepsy is largely determined by the correct calculation of the dose and duration of treatment. Depending on the symptomatic manifestations, the names of recommended drugs may belong to different groups of drugs:

• Anticonvulsants. Drugs belonging to this group of drugs help relax muscle tissue. They are often recommended for the treatment of various forms of epilepsy. Such drugs can be prescribed to both adults and children in the presence of tonic-clonic and myoclonic seizures.
• Tranquilizers. The purpose of drugs in this group is to relieve or suppress nervous excitability. They help in the fight against the manifestations of minor seizures. However, such drugs are used with caution, since at the beginning of use they can aggravate the severity of the disease.
• Sedatives. Not all epileptic seizures end well. Often, immediately before or after a seizure, the patient falls into severe depressive states, becomes irritable or aggressive. Sedatives in combination with a visit to a psychotherapist can calm and relieve such symptoms.
• Injections. Used for twilight states and affective disorders. Injections of nootropic drugs (Actovegin, Cerebrolysin, etc.) have proven themselves well as a means to alleviate and localize some symptoms of neurological disorders.

Medicinal assistance for seizures of various types

Every person with epilepsy, as well as his loved ones, should clearly know the form and type of medication. Sometimes, during an attack, every second can be the last.

Depending on the form of diagnosis, the patient may be prescribed the following medications:

1. Acetazolamide . It is prescribed for absence seizures that are not relieved by other medications.
2. Carbamazepine, Lamotrigine . Designed to eliminate generalized and partial types of epilepsy.
3. Clonazep . Fights atonic, myoclonic, atypical absence seizures, and is also acceptable in the treatment of childhood seizures.
4. Valproic acid . This remedy helps in most cases, which is why doctors recommend that epileptics always have it with them. Eliminates absence seizures, generalized and partial seizures, febrile seizures, myoclonic and atonic seizures, as well as infantile spasms.
5. Ethosuximide . Helps only with absence seizures,
6. Gabapent . Intended for the treatment of partial seizures.
7. Felbamate . Eliminates absence seizures of atypical nature and partial type seizures.
8. Phenobarbital, Phenitol . It is prescribed for patients with generalized tonic-clinical epilepsy, as well as for partial seizures.
9. Topiramate . It has similar help as the previous drug, but at the same time it can eliminate absence seizures.

To choose the right medicine, the patient must be fully examined.

Effect of medications

It is known that if you regularly and promptly take anticonvulsant drugs for epilepsy, you can completely control the occurrence of epileptic seizures. Modern medications allow:

• block the excitability system of neurons of the epileptic focus;
• stimulate the activity of the inhibitory complex of gamma-aminobutyric acid receptors;
• influence ion channels and stabilize neuronal membranes.

Prescribed tablets for epilepsy may have either one of these mechanisms of action or a complex of them. Modern antiepileptic drugs are conventionally divided into drugs of the 1st line (basic category) and 2nd line (drugs of the latest generations). Depending on the symptoms, the doctor recommends taking certain medications.

Anticonvulsants

Their main task is to block seizures and relieve tension in the affected area of ​​the brain.

The mechanism of action of such drugs for epilepsy in humans is as follows:

1. GABA receptors are stimulated, which sharply reduce the activity of neurons.
2. The amount of glutamate decreases; it is a neurotransmitter that has a stimulating effect on the nervous system.
3. The source of excitation is activated in the brain due to an incorrect ratio of ions in the cell membrane; these drugs normalize this process by blocking ion channels.

As a rule, the doctor selects one drug, carefully examining possible side effects.
These funds are divided into 2 groups. Class 1 includes medications that have been used for a long time: Carbamazepine, Benzobarbital, etc. The second includes those containing Phenobarbital and other potent drugs.

Basic category of antiepileptic drugs

In our country, basic therapy drugs are used as the main treatment for signs of epilepsy. The list of these drugs includes drugs that have been tested over many years of use and have good results in treatment. These include:

• Phenobarbital (Luminal);
• Primidone (Hexamidine);
• Benzobarbital (Benzene);
• Lamotrigine;
• Phenytoin (Difenin, Epanutin);
• Carbamazepine (Tegretol, Finlepsin);
• Valproic acid and its salts (Konvulex, Depakine);
• Ethosuximide (Petnidan, Suxilep, Zarontin);
• Levetiracetam (Keppra, Levetinol, etc.).

This is not the entire list of medications that are recommended for epileptics to take. The choice of a particular medication depends on the form of the disease, the nature of the attacks, the age and gender of the patient.

What drugs should not be taken or should their use be significantly limited?

It is impossible to strictly name a list of contraindicated or dangerous medications. Based on the clinical recommendations of most specialized communities, any psychotropic drugs are prescribed with great caution: antidepressants, tranquilizers, antipsychotics. Also, do not abuse oral contraceptives, nootropics, cerebrovascular, non-steroidal anti-inflammatory drugs and glucocorticoid-based medications.

All kinds of “folk” remedies are strictly contraindicated. Grandmother's recipes are not an option in the treatment of epilepsy. Drugs are prescribed by a doctor taking into account all possible factors.

Drugs contraindicated for epilepsy are only conditionally contraindicated. Exceptions are always possible.

2nd line drugs

Drugs belonging to the second category of antiepileptic drugs do not have the same spectrum of action or have a larger list of contraindications than the basic ones. Luminal, Diacarb, Lamictal, Sabril, Frisium or Seduxen have a good therapeutic effect and are also often recommended as effective pills for epilepsy, but for a short time.

The list of drugs for the treatment of epilepsy is very long. Epilepsy must be treated by a doctor. Self-selection of medications and inadequate self-medication can lead to death.

Constant companions of epilepsy are migraine and depression. It has been proven that in patients suffering from migraines, manifestations of epilepsy occur much more often. It was found that depressive states in people with controlled seizures occur 20% less often than in people with uncontrolled seizures.

Neuroprotectors

Simply put, this disease is a pathological activation of brain neurons. The task of drugs in this group is to block this activation and regulate their correct effect on the cell membrane.

Gliatilin for epilepsy:

• Made in Italy, available with prescription;
• increases the elasticity of cell membranes;
• the course of treatment is 3-6 months;
• Side effects include possible nausea;
• taken in tablet form 3 times a day; intravenously – 1 time;
• Contraindicated during pregnancy and lactation.

Cereton:

• has a similar spectrum of action;
• costs a little less;
• Available in the form of capsules and ampoules;
• admission rules are the same;
• Contraindicated for children under 18 years of age and pregnant women.

Choline Alfoscerate:

• contains the active substance corresponding to the name;
• Available in the form of a solution for injection;
• Russian production, recipe;
• costs much less than analogues;
• also active in ischemic stroke;
• side effects - nausea, gastrointestinal disorders, frequent urination.

Polytherapy: combined treatment regimen

When treating this pathology, the doctor strives to achieve monotherapy. This allows you to select the appropriate drug, optimal dosage and appropriate treatment regimen, as well as achieve high clinical effectiveness. In addition, monotherapy minimizes the side effects of treatment.

However, in some situations it is more advisable to choose a combined drug regimen. This is what they do:

• In the form of the pathological process, which combines several types of attacks and there is no possibility of complete monotherapy;
• For conditions accompanied by the same type of epileptic seizures, but not treatable with any medication.

In these cases, medications with different mechanisms of action are used in treatment regimens. However, the chosen treatment tactics must be rational and combine drugs that do not interfere with each other. For example, a prohibited combination is the simultaneous use of phenobarbital with primidone and benzobarbital or phenytoin with lamotrigine.

When using a combined treatment technique, a slight decrease in the therapeutic effect is possible. Often, patients experience signs of intoxication when using one of the drugs that was previously well tolerated. Therefore, at the initial stages of polytherapy, monitoring the level of drugs used in the blood plasma is necessary.

Painkillers

Sometimes attacks are accompanied by pain. In these cases, doctors solve several problems at once:

• relief of severe pain;
• preventing its manifestation in the future;
• return of the patient to physical activity.

In this case, remedies are chosen without pronounced side effects; there are already enough of them for such an illness.

Cinnarizine for epilepsy:

• Bulgarian prescription drug in tablet form;
• has not only an analgesic, but also a vasodilator effect without affecting blood pressure;
• taken after meals in doses up to 25 mg;
• Use with caution during pregnancy and Parkinson's disease.

Mexidol:

• It is believed that with similar effects, the drug also improves memory;
• causes a minimum of allergic reactions;
• Recently the drug has been declared a prescription drug.

Duration of treatment

The cessation or reduction of epileptic seizures, reducing their duration, alleviating and improving the psycho-emotional state of the patient is already considered a positive trend in treatment. The use of the latest pharmacotherapy techniques makes it possible to achieve complete relief or significant minimization of seizures.

The duration of drug therapy is determined by the type of attacks and form of the disease, age and individual characteristics of the patient. Practical recovery can occur with idiopathic forms of epilepsy. A small percentage of relapses occur in idiopathic forms with absence seizures that occur in childhood or adolescence. Cancellation of treatment for low-recurrence epilepsy is possible after two years of remission. In other cases, the question of stopping therapy can be raised only after five years of remission. In this case, the EEG should show a complete absence of pathological activity.

Termination of therapeutic treatment is carried out gradually, with a reduction in dosage to 1/8 daily over 6-12 months. Antiepileptic therapy should not be discontinued in patients with severe symptoms.

General principles of therapy

The basis of therapy for the pathological process under consideration is the solution of several issues:

1. Eliminate symptoms. The clinical picture against the background of a neurological disorder is painful and severe, which leads to avoidant behavior and the formation of phobias. The attacks themselves develop suddenly, sometimes at a dangerous moment. There is a risk of non-life-threatening injury. The first task is to eliminate symptoms, if any.
2. The second goal is to prevent relapses. Seizure episodes are eliminated through the use of the same drugs, but in larger dosages or the use of second-line drugs, additional medications. The issue is resolved at the discretion of the treating specialist.
3. The third problem to be solved is eliminating the root cause of the neurological disorder. It makes sense to undergo a full diagnosis. There are many treatment options; conservative correction does not always make sense.

In most cases, tablets alone are not enough. This is a key way of curation. However, psychotherapy may be required to eliminate anxiety and the phobic component (which, by the way, can provoke relapses and repeated more severe seizures). All assigned tasks are solved simultaneously; therapy may take more than one year. In most cases, patients are forced to take pharmaceuticals for life.

Alternative Treatments

Among the variety of alternative treatment methods, homeopathic treatments occupy a special place. Although epilepsy cannot be completely cured, this treatment method has its advantages. For example, the use of homeopathic recipes brings a tangible therapeutic effect, affecting the entire body. Homeopathic procedures are non-addictive and easy to use. In addition, they have a low cost.

It is worth taking into account that such therapy is safe and gentle on the body. The obvious advantages of such methods include the fact that this is the only method that does not have a toxic effect on tissues and organs.

Precautions when using drugs

There are two recommendations: do not stop the drug abruptly. This will provoke the opposite effect and a difficult criminal period. At best, a one-time paroxysm will occur. The second recommendation is not to prescribe treatment to yourself. This is a road to nowhere.

In addition, it is necessary to minimize provoking factors: stress, sharp sounds, bright light, physical activity, temperature changes and others. Pills alone won't help matters. Psychotherapy is almost always required. Do not miss the basis of treatment - eliminating the root cause of the disorder.

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