About 1 in 26 people will develop epilepsy in their lifetime — which means clear, practical information matters. If you or someone you care about has seizures, the goal is simple: stop or reduce seizures with the fewest side effects so you can live your life. Here’s a straight talk on what actually works, what to watch for, and when to get urgent help.
Anti-seizure medications are the first step. Some commonly used drugs are levetiracetam (Keppra), lamotrigine, carbamazepine, valproate (Depakote), topiramate, and phenytoin. Each works a bit differently and has different side effects: for example, levetiracetam can cause mood changes, lamotrigine risks a rare skin rash if started too fast, and valproate can harm a fetus — so doctors avoid it in women planning pregnancy when possible.
Expect follow-up blood tests for some meds and regular check-ins to adjust dose. Drug interactions matter: enzyme-inducing drugs can reduce hormonal birth control effectiveness, and some combinations raise the risk of drowsiness or dizziness. Stick to the prescribed dose — missing pills is a common reason seizures return.
If seizures continue on two well-chosen medications, other treatments can work. Surgery (like temporal lobectomy) removes a clearly defined seizure focus and can be curative for some people. Neurostimulation options include vagus nerve stimulation (VNS) and responsive neurostimulation (RNS), which reduce seizures for many patients. For children and some adults, a ketogenic or modified Atkins diet can cut seizures dramatically. Cannabidiol (Epidiolex) has approval for certain severe childhood epilepsy syndromes too.
Choosing a path often means testing: video-EEG monitoring, brain MRI, and sometimes neuropsychological testing. A multidisciplinary epilepsy center gives the best shot at finding the right mix of treatments.
Everyday management matters. Poor sleep, alcohol, missed meds, and stress often trigger seizures. Simple habits — regular sleep, a medication routine, and avoiding alcohol binges — make a real difference. Safety adjustments are practical: supervised swimming, showering instead of baths if seizures are uncontrolled, stove safety, and helmets for activities with fall risk.
Seizure first aid you should know: stay calm, time the seizure, move sharp objects away, protect the person’s head, and don’t put anything in their mouth. Call emergency services if the seizure lasts more than 5 minutes, if repeated seizures occur without recovery, or if the person has trouble breathing or a serious injury.
When to see a specialist? New-onset seizures, a cluster of seizures, side effects from meds, planning pregnancy, or ongoing seizures despite treatment — those are triggers to get to an epilepsy clinic. With the right team and realistic plan, many people with epilepsy have good seizure control and a full life.
