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Anti Epileptic Medication

The number of medicines licensed for the treatment of epilepsy has greatly increased in the last twenty years. This does not mean that all patients diagnosed with epilepsy can expect to gain complete control over their seizures with the regular use of prescribed medication. Even the most optimistic prescribers suggest that a success level approaching 70% is the best that can be expected and then after only after various medications and dosages have been tried. These anti-epileptic drugs (AEDs) are not used to stop seizures whilst they are in progress and they do not cure epilepsy. For Information on particular medicines click here  It is important that a degree of patience is observed during the search for the best level and type of medication to control their seizures because as with most medicines the beneficial effects are come at the cost of unwanted side effects. In fact the development of new medicines is linked as much to limiting side effects as providing greater seizure control.

 Different drugs work in different ways, but those for epilepsy  all aim to stop seizures happening. Before starting them, it is important that your neurologist finds out as much as possible about your epilepsy. This is because the medication that they prescribe depends on making sure you have epilepsy and finding the type(s) of seizures you have. The medication will need to be taken regularly and probably  over a number of years. Your neurologist will take into account any other medical conditions you may have and the medication for those to make sure there is no contra-indication. Medications have bothj a proprietary and generic name as explained at the following page

Before starting you on them, it is important that your neurologist finds out as much as possible about your epilepsy. This is because the medication that they prescribe depends on making sure you have epilepsy and finding the type(s) of seizures you have. The medication will need to be taken regularly and often over a number of years. Your neurologist will take into account any other medical conditions you may have and the medication for those to make sure there is no contra-indication which would cause undesirable side effects. 

From Wednesday 11 January2012, doctors  have new advice on the drugs they should prescribe their patients who have epilepsy. This comes as the National Institute for Health and Clinical Excellence (NICE), the healthcare guidance body, updates the pharmacological recommendations from its clinical guideline on the diagnosis and management of the condition.

The guideline has been revised to fully incorporate newer anti-epileptic drugs (AEDs) which have emerged in UK clinical practice since the original guidance was published in 2004.

Carbagen SR (prolonged release carbamazepine) tablets are out of stock in all doses. Mylan, the makers of Carbagen SR, does not know when it will have these tablets back in stock.

Standard release Carbagen tablets are in stock in 200mg and 400mg doses.

If you usually take Carbagen SR, speak to your GP, epilepsy nurse or epilepsy specialist for advice. You may need to temporarily switch to a different version of carbamazepine until Carbagen SR is back in stock.

EMA medicine safety committee recommends stronger restrictions on use of sodium valproate in women of childbearing age The new recommendations say that for women with epilepsy, sodium valproate should not be used during pregnancy. However, the recommendations acknowledge that in some women with epilepsy, it may not be possible to stop using the medicine. This is because it may lead to breakthrough or worsened seizures, which can be harmful to the woman and baby. In this situation, the recommendations say women should have appropriate specialist care. In women of a childbearing age, the recommendations say that sodium valproate should not be used unless measures are taken to help the woman avoid becoming pregnant. The PRAC suggests that a pregnancy prevention programme should be created for this. The pregnancy prevention programme would assess the potential of a woman becoming pregnant, depending on her circumstances. It would suggest pregnancy tests are taken during the treatment as needed. The committee says counselling should be provided about the risks to pregnancy as part of the programme. It also suggests that there should be annual reviews of the treatment. PRAC recommends that a risk acknowledgement form should be introduced, for people to go through with their doctors at each review. Alongside these recommendations, the committee has also said that there should be a visual warning on the medicines’ packaging. They recommend a symbol or a pictogram. A reminder card should also be attached to the packaging to help pharmacists discuss the risks of valproate. The committee is also calling on companies marketing the medicine to provide updated educational materials. 

Ask for repeat prescriptions in plenty of time!

People with epilepsy are being urged not to leave it to the last minute to get their prescriptions for anti-epileptic drugs (AEDs) dispensed. The National Society for Epilepsy inform  that recent press reports have highlighted shortages in supply of some drugs to UK patients which, it is claimed, are being sold overseas for higher prices.They (NSE) are urging patients to present their prescription to their pharmacist well before they run out of their medication.NSE’s chief pharmacist Janet Clark said:  “There have been problems with the supply of some AEDs for a little while.  Pharmacists are aware that there are alternative ways of obtaining the drugs to ensure continuity of supply but this can take an extra day or so.  I would urge patients not to leave getting their prescriptions to the last minute.The medicines and healthcare regulator, the MHRA, has issued guidance aiming to reduce future problems with the export of medicines for profit.

Anyone wanting to talk about this or any other issues regarding epilepsy can contact theEpilepsy Society's helpline on 01494 601400 or visit the website at http://www.epilepsysociety.org.uk

Click here for Information on particular medicines

This introduction is in line with the recommendations of the EpilepsySociety and further information can be found on the Epilepsy Website

 

Cannabidiol

Although there have been several reports of cannabidiol (CBD) being effective in some forms of childhood epilepsy, no no licenses have been so far granted by the MHRA in the UK . There are trials in progress in America, but until the results are available we won't know if it has promise as an epilepsy treatment. Even if it does show potential, many more follow-up studies will be necessary before it can be approved by the FDA (the medicines regulatory body in the US); and further studies still will be needed before the MHRA (the UK medicines and healthcare regulatory body) will licence it. The reports to date are certainly compelling, but the numbers are too few to serve as robust evidence. It would be unethical for Epilepsy Research UK comment on the effectiveness of  the treatment of epilepsy at this stage. In the absence of rliable research there is no reason to believe that they will prove effective in eliminating or controlling seizures.

The latest trials of cannabis in the treatment of children with epilepsy suggest a pure form of the drug may be of benefit. But Professor Helen Cross of Great Ormond Street Hospital, London, stressed that the benefit may be no greater than that of one of the new, standard anti-epileptic drugs.Speaking at the 31st International Epilepsy Congress in Istanbul, she said there was a lot of interest in the use of cannabis in treating seizures but that more tests were needed to evaluate the safety and efficacy of the drug. ‘We have to be particularly concerned about the effects of the drug on the developing brain in children,’ she said.

 For reliable information on any aspect of epilepsy search here