Mental health articles

Prescribing drugs for a person with epilepsy
• Select the drug of choice for the particular type of epilepsy. In general, carbamazepine is an effective and safe drug for both main types of epilepsy in adults. Sodium valproate is another
effective drug. Phenytoin and phenobarbitone are useful mainly for generalised epilepsy.
• Cost and side-effects are both important issues in selecting drugs since the medicines have to be continued for a long period. If cost is not a limitation, use carbamazepine or sodium valproate as
the drug of choice. If cost is a factor, phenobarbitone may be considered .
• Use only one drug at a time. Start with a small dose and gradually increase until you reach the average recommended daily dose.
• If seizures continue without any benefit, try increasing the dose to the maximum recommended dose; if side-effects appear, do not go any higher.
• If available, use blood drug levels to help monitor the treatment.
• Educate regarding lifestyle changes before increasing drug doses .

• If seizures continue at an unacceptable frequency, add a second drug in a small dose and increase
as required.
• Generally, do not consider stopping the medicine unless the person has been free of seizures for at least two years. Never stop the medicine suddenly; withdraw it slowly in small steps, for
example a quarter of the total daily dose every month.
• Treat mental illnesses such as depression and psychoses as with anyone else.

Tags: drugs, epilepsy