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. We quote an expert summary of the medication you are likely to be prescribed if you are diagnosed as having epilepsy.
"In general, epilepsy treatment is long-term, so minimisation of adverse effects is key. The composite outcome measure of time remaining on treatment takes efficacy and adverse effects into account. This meta-analysis supports NICE evaluations (2004, 2012) that carbamazepine and lamotrigine are suitable for focal seizures and levetiracetam is an alternative. Also, valproate is effective for generalised tonic-clonic seizures, with lamotrigine and levetiracetam alternatives, particularly if pregnancy is contemplated.
The availability of many medications that suppress seizures brings choice and the ability to minimise adverse-effects, but these have not affected remission rates. We await therapies that prevent the development of epilepsy and alter its natural history.
John Duncan, Professor of Neurology, UCL; Divisional Clinical Director, National Hospital for Neurology and Neurosurgery"
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 had 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