Book contents
- Seizure and Epilepsy Care
- Seizure and Epilepsy Care
- Copyright page
- Contents
- 1 How Do I Evaluate a First-Time Seizure?
- 2 How Do I Make an Epilepsy Diagnosis?
- 3 Which Antiseizure Medicines Treat Epilepsy and How Do I Pick?
- 4 How Can I Best Use EEG for Treating Epilepsy Patients?
- 5 What Are Common Epilepsy Imaging Findings in New Onset and Chronic Epilepsy Care?
- 6 How Do I Care for Patients in the Emergency Department and Inpatient Settings?
- 7 How Do I Manage Epilepsy Emergencies Like Status Epilepticus?
- 8 What Is the Best Long-Term Treatment Plan for Epilepsy Patients as an Outpatient?
- 9 What to Do When Your Patient Fails Two Antiseizure Medicines
- 10 Nonepileptic Events and General Psychiatric Care for Epilepsy Patients
- 11 What Are Essential Pediatric Epilepsy Clinical Diagnoses and Treatment Plans?
- Index
- References
3 - Which Antiseizure Medicines Treat Epilepsy and How Do I Pick?
Published online by Cambridge University Press: 28 January 2023
Book contents
- Seizure and Epilepsy Care
- Seizure and Epilepsy Care
- Copyright page
- Contents
- 1 How Do I Evaluate a First-Time Seizure?
- 2 How Do I Make an Epilepsy Diagnosis?
- 3 Which Antiseizure Medicines Treat Epilepsy and How Do I Pick?
- 4 How Can I Best Use EEG for Treating Epilepsy Patients?
- 5 What Are Common Epilepsy Imaging Findings in New Onset and Chronic Epilepsy Care?
- 6 How Do I Care for Patients in the Emergency Department and Inpatient Settings?
- 7 How Do I Manage Epilepsy Emergencies Like Status Epilepticus?
- 8 What Is the Best Long-Term Treatment Plan for Epilepsy Patients as an Outpatient?
- 9 What to Do When Your Patient Fails Two Antiseizure Medicines
- 10 Nonepileptic Events and General Psychiatric Care for Epilepsy Patients
- 11 What Are Essential Pediatric Epilepsy Clinical Diagnoses and Treatment Plans?
- Index
- References
Summary
Antiseizure medicines (ASMs) are medicines that reduce seizure frequency. They work by influencing cellular electrical channels like sodium or neurotransmitters like GABA. They are very effective, with 65% of patients seizure-free within the first three ASMs that they take. Unfortunately, less than 1% of people are seizure-free with ASMs after failing three ASMs. These data inform the definition of drug-resistant epilepsy, which is failing two ASMs. Newer ASMs have not been found to be more effective. Lamotrigine has been shown to be better tolerated compared to several other medications. Divalproex has been specifically shown to be most effective for generalized epilepsy, but has a challenging side effect profile, particularly in women. Side effects can be a cause of poor ASM compliance. Proactively accounting for patient factors like psychiatric comorbidity or renal impairment can lead to better tolerability and thus improved compliance. Monotherapy is typically preferred. Polytherapy can be considered in specific situations as well.
- Type
- Chapter
- Information
- Seizure and Epilepsy CareThe Pocket Epileptologist, pp. 41 - 56Publisher: Cambridge University PressPrint publication year: 2023
References
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