What is the best medicine for seizures?

Answered by Shivam Patel, PharmD, BSPS, RPh | Posted January 20, 2020

When people think of seizures, they often imagine convulsions: a body shaking uncontrollably. It is important to know that not all seizures occur in this way. Epilepsy is a disorder of the brain that causes a symptom of seizures. Seizures occur due to abnormal electric activity in the brain. According to the CDC, 1.2% (3.4 million people) of the total US population had active epilepsy in 2015

What treatments are available for seizures?

Treatments for seizures are based on the cause. Treating the cause of the seizures helps prevent future seizure episodes from occurring. Treatments can include the following:

  • Medication therapy
  • Nerve stimulation
  • Surgery for brain abnormalities correction
  • Ketogenic diet

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What is the best medicine for seizures?

The “best” medicine depends on the condition of the person who needs it. Seizure medication must be tailored by your clinician for what fits you best. There are two types of seizure drugs: narrow-spectrum antiepileptic drugs (AEDs) and broad-spectrum AEDs. Some people may have to take more than one medication to prevent seizures from occurring.

Narrow-spectrum AEDs are indicated for specific types of seizures. Your clinician would prescribe these drugs to target seizures that occur regularly in a particular part of your brain.

Narrow Spectrum Antiepileptic Drugs

Generic Name Brand Name(s) Indication(s)
Carbamazepine Carbatrol, Tegretol, Epitol, Equetro Partial seizures (psychomotor, temporal lobe)   Generalized tonic-clonic seizures (grand mal)
Clobazam Onfi Seizures associated with Lennox-Gastaut syndrome
Diazepam Valium, Diastat Cluster seizures
Divalproex Depakote Partial seizures Absence seizures
Eslicarbazepine acetate Aptiom Partial seizures Focal seizures
Ethosuximide Zarontin Absence seizures
Gabapentin Neurontin, Gralise Partial seizures
Lacosamide Vimpat Partial seizures
Methsuximide Celontin Absence seizures
Oxcarbazepine Trileptal, Oxtellar XR Focal seizures
Perampanel Fycompa Partial seizures
Phenobarbital Luminal Partial seizures Generalized seizures
Phenytoin Dilantin, Phenytek Partial seizures Tonic-clonic seizures
Pregabalin Lyrica Partial seizures
Rufinamide Banzel Seizures associated with Lennox-Gastaut syndrome
Tiagabine hydrochloride Gabitril Partial seizures
Vigabatrin Sabril Partial seizures

Broad-spectrum AEDs are indicated for many types of seizures. Your clinician would prescribe these drugs to target seizures that occur regularly in more than one part of your brain.

Broad Spectrum Antiepileptic Drugs

Generic Name Brand Name(s) Indication(s)
Clonazepam Klonopin Absence seizures Myoclonic seizures Cluster seizures
Clorazepate Tranxene-T Partial seizures
Ezogabine Potiga Generalized seizures Focal seizures
Felbamate Felbatol Partial seizures Tonic-clonic seizures Generalized seizures Focal seizures
Lamotrigine Lamictal Focal seizures Tonic-clonic seizures Seizures associated with Lennox-Gastaut syndrome
Levetiracetam Keppra, Spritam Generalized seizures Focal seizures
Lorazepam Ativan Generalized seizures Focal seizures Seizures associated with Lennox-Gastaut syndrome
Primidone Mysoline Generalized seizures Focal seizures
Topiramate Topamax, Qudexy XR, Trokendi XR Generalized seizures Focal seizures Seizures associated with Lennox-Gastaut syndrome
Valproic acid Depacon, Depakene, Depakote, Stavzor Absence seizures Partial seizures
Zonisamide Zonegran Generalized seizures Focal seizures
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How much do epilepsy medications cost?

Most AED medications are available as a generic in the U.S. but can be expensive if you don’t shop around for the lowest prices. There are also newer brand medications that can be very expensive. The average retail price for 30 tablets of Aptiom eslicarbazepine in the U.S. is $1166.88. The generic version of Aptiom is available at Accredited International Pharmacies for a low price of $149.99: an 87% discount! Using a discount card from PharmacyChecker, you can find an 81% savings on generic lamotrigine compared to the average retail price in the U.S. You can search for more AED medication discounts below.

Four common medications used to help control epilepsy include the following:

Compare Generic Antiepileptic Medication Costs

Generic Name Brand Name Average U.S. Retail Price PC Discount Card Price (in ZIP Code 10605) Lowest Accredited International Pharmacy Price Greatest PharmacyChecker Savings
carbamazepine 200mg Tegretol $30.03 $23.38 $11.19 63%
divalproex ER 500mg Depakote ER $118.68 $50.05 $19.67 83%
eslicarbazepine 800mg Aptiom $1166.88* - $149.99 87%
lamotrigine 100mg Lamictal $46.16 $8.65 $33.99 81%
felbamate 600mg Felbatol $180.87 $65.68 - 64%

Prices collected December 2019 for quantity of 30 tablets | *Brand Only Available in US

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Where are seizure medications manufactured?

We found a label of Tegretol sold in the U.S. that shows it is a "Prodcut of Switzerland" manufactured by Patreon Manufacturing Services LLC and distributed by Novartis.

tegretol manufacturing label

We found a label of Depakote ER sold in the U.S. that shows it is manufactured by Abbvie in Puerto Rico.

depakote manufacturing label

We found a label for Aptiom sold in the U.S. that shows it is made in Canada by Sunovion Pharmaceuticals Inc.

aptiom manufacturing label

We found a label for Lamictal sold in the U.S. that shows it is made in India and distributed by GlaxoSmithKline.

lamictal manufacturing label

We found a label for Felbatol sold in the U.S. that shows it is manufactured for Meda Pharmaceuticals.

felbatol manufacturing label

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What types of seizures are there?

According to the International League Against Epilepsy (ILAE), there are two major types of seizures: Focal seizures and Generalized seizures.

Focal Onset Seizures

Focal onset seizures, formerly known as partial onset seizures, occur in a single part of the brain.

When you can sense that you are having a seizure, it is known as a focal aware seizure.

If you're unaware when the seizure occurs, it's known as a focal impaired awareness seizure. Some people may experience cluster seizures during which they have a partial seizure in the morning and three to four more seizures throughout the day.

Generalized Onset Seizures

Generalized Onset seizures start in both sides of the brain at the same time. The most common types of generalized onset seizures include absence, tonic-clonic, and atonic.

  • Absence (Petit-mal seizures)

    Petit-mal seizures occur for only a few seconds. They cause people to blink rapidly or stare into space.

  • Tonic-clonic (Grand mal seizures)

    “Tonic” refers to stiffening of the muscles. “Clonic” refers to the irregular arm and leg movements when convulsions occur. People who experience tonic-clonic seizures can lose consciousness, fall to the ground and cry out. These seizures can last for a few minutes and people often feel tired after it concludes.

  • Atonic (Drop attacks)

    “Atonic” refers to relaxation of the muscles. These seizures cause your muscles to suddenly go limp or flop. It can cause people to nod their head or cause the entire body to fall. These seizures occur for about 15 seconds.

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What are the symptoms of a seizure?

Believe it or not, focal and generalized seizures can actually occur at the same time or back to back. Symptoms of these seizures generally last from seconds to 15 minute episodes.

Symptoms that can occur before the seizure takes place can include the following:

  • Dizziness
  • Headache
  • Suddenly feeling fearful or anxious
  • Changes in your vision
  • Irregular arm or leg movements
  • Feeling an “out of body” sensation

Symptoms that can occur during a seizure include the following:

  • Irregular and uncontrollable muscle spasms
  • Losing consciousness or fainting then feeling confused afterwards
  • Falling all of a sudden
  • Sudden mood change
  • Mouth drooling or frothing
  • Grunting or making unusual noises
  • Clenching of teeth
  • Biting of tongue
  • Strange or weird taste in your mouth
  • Rapid eye movements
  • Lost control of bladder or bowel
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What causes seizures?

Seizures can occur from numerous health conditions. Any activity that affects the body and provides the brain disturbance can lead to a seizure. Examples of causes include the following:

  • Epilepsy
  • Lennox-Gastaut syndrome
  • Brain tumor
  • Stroke
  • Fever
  • Choking
  • Low blood sugar
  • Trauma to the head
  • Withdrawal from alcohol
  • Withdrawal from drugs
  • Drug abuse
  • Brain infection like meningitis
  • Brain injury while giving birth
  • Brain defect from birth
  • Electrolyte imbalance
  • Liver or kidney failure
  • Extremely high blood pressure
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What can I do when someone is having a seizure?

Try to remain calm. Acknowledge there is no way to stop a seizure that is in progress, but you can provide vital help. The CDC provides some first aid tips:

Epilepsy First Aid Tips

Seizures do not often require emergency medical attention. Only call 911 if one or more of the following are true:

  • The person has never had a seizure before.
  • The seizure occurs for longer than 5 minutes.
  • The person has a hard time breathing or waking up after the seizure.
  • Another seizure occurs right after the first one.
  • The person gets hurt during the seizure.
  • The seizure occurs in water.
  • The person is pregnant or has an existing health condition such as heart disease.

Most seizures stop in a few minutes. General steps to help when a seizure in progress include the following:

  • Stay with the person until the seizure stops and the person is fully awake.
  • Help the person sit comfortably in a safe place.
  • When they are able to communicate and alert, let them know what happened calmly.
  • Check for a medical bracelet or other emergency information on the person.
  • Offer to call an uber or a caregiver to ensure the person reaches home safely.
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Learn more about drug prices and affording medication in the U.S.

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Do you have questions or concerns about prescription drug savings, whether locally or online? We’re here to help.

Comment below or ask a question by logging in to My PharmacyChecker.

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Updated January 22, 2020

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