Overview of 7 most common seizure medications

Over the past century or so, scientists have discovered an ever-growing range of anti-seizure medications. Today, there are around 30 epilepsy medications approved in the US. They all work slightly differently, and help treat different sorts of seizures. 

Since there are so many anti-seizure medications (ASMs) out there, it can get confusing talking to your doctor or pharmacist about them. We’ve compiled this anti-seizure medications list to help you learn more about seven of the most widely used first line ASMs in the US. 

Of course, this anti-seizure medications list doesn’t cover every medication or all information about how they work. The Epilepsy Foundation maintains a reliable list of all ASMs currently approved in the US. If you have any questions about anti-seizure medications, ask your doctor for more detail. 

‍Suggested: Why might an ASM not work for you?

7 common first line anti-seizure medications

When people are first diagnosed with epilepsy, physicians usually begin by using medication to treat the condition. The seven ASMs in this list are some of the most common ‘first line’ medications used for different kinds of epilepsy. 

For some people, these ‘first line’ medications may be effective. But for others, the ASM either doesn’t work, or the anti-seizure medication side effects are very unpleasant. If so, their doctor may try an alternative medicine. For about one-third of people with epilepsy, ASMs may not provide full seizure control. But there are other treatment options available. If an anti-seizure medication doesn’t seem to be working for you, speak with your doctor about this. 

This article is intended for informational purposes only, and is not medical advice. If you take anti-seizure medication, you must follow your doctor’s instructions about dosage, quantity and timing.

1. Valproic Acid

Brand names: Depakote, Depakene, Stavzor, Depacon

Form: May be taken as tablets, liquids, or granules (sprinkled on food)

Treats:  Focal impaired awareness seizures and absence seizures as a first line treatment, and other seizure types as a secondary (adjunctive) treatment

Since being introduced in 1978, Valproic Acid has become one of the most widely prescribed ASM in the world. 

Valproic Acid works by calming overactive brain cells, which can help prevent seizures. 

Possible Valproic Acid side effects include:

• Nausea 
• Headache 
• Sleepiness 
• Vomiting 
• Weakness 
• Tremor 
• Dizziness 
• Stomach pain 
• Blurry vision 
• Double vision 
• Diarrhea 
• Increased appetite 
• Weight gain 
• Hair loss 
• Loss of appetite 
• Problems with walking or coordination

Be aware that there may be other, less common side effects you could experience. Always check the leaflet and discuss these risks with your doctor.

2. Lamotrigine

Brand names: Lamictal

Form: Comes as tablets people can swallow or chew

Treats: Generalized (tonic clonic) seizures; focal seizures

Lamotrigine is a widely used anti-seizure medication among people with generalized and focal epilepsy. It works by slowing down the abnormal electrical activity in the brain that can cause seizures.

Possible Lamotrigine side effects include:

• Dizziness 
• Tremor 
• Headache 
• Rash 
• Blurred or double vision 
• Fever 
• Lack of coordination 
• Abdominal pain 
• Sleepiness 
• Back pain 
• Nausea, vomiting, diarrhea 
• Tiredness 
• Insomnia 
• Dry mouth

Be aware that there may be other, less common side effects you could experience. Always check the leaflet and discuss these risks with your doctor.

3. Topiramate

Brand names: Trokendi XR, Qudexy XR, Topamax, Eprontia, Topiragen

Form: Comes as tablets to swallow

Treats: Generalized (tonic-clonic) seizures and focal seizures

Topiramate is used to treat both focal and generalized epilepsy. Like many other ASMs, it works by calming overactive brain activity, which can help prevent seizures. 

Possible Topiramate side effects include:

• Tingling of the arms and legs (paresthesia) 
• Not feeling hungry 
• Nausea 
• A change in the way foods taste 
• Diarrhea 
• Weight loss 
• Nervousness 
• Upper respiratory tract infection

Be aware that there may be other, less common side effects you could experience. Always check the leaflet and discuss these risks with your doctor.

Issues with ASMs: Anti-seizure medicine side effects

4. Carbamazepine

Brand names: Tegretol, Epitol, Equetro, Carbatrol, 

Form: Comes as tablets, liquids and suppositories

Treats: Focal seizures and generalized seizures

Carbamazepine is a sodium channel blocker used to treat epilepsy. It works by slowing down the electrical signals in the brain, which can help prevent seizures. 

Possible side effects from Carbamazepine include:

• Drowsiness
• Dizziness
• Problems with walking and coordination (unsteadiness) 
• Nausea 
• Vomiting

Be aware that there may be other, less common side effects you could experience. Always check the leaflet and discuss these risks with your doctor.

5. Phenytoin

Brand names: Dilantin, Phenytek

Form: Comes as tablets for swallowing or chewing and as a liquid

Treats: Tonic-clonic seizures; temporal lobe seizures 

Phenytoin was first approved by the FDA in 1939. It works by to work by slowing down abnormal electrical activity in the brain, which can help prevent seizures.  

Possible Phenytoin side effects include:

• Irregular movement of the eye
• Problems with movement and balance
• Slurred speech
• Decrease in coordination
• Drowsiness
• Confusion

Be aware that there may be other, less common side effects you could experience. Always check the leaflet and discuss these risks with your doctor.

6. Oxcarbazepine

Brand names: Trileptal, Oxtellar XR

Form: Comes as tablets form, or as a liquid

Treats: Focal seizures

Oxcarbazepine is is used to treat focal seizures and is available in both immediate- and extended-release forms. It works by blocking sodium channels in the brain, which helps slow down abnormal electrical activity that can cause seizures. 

Possible Oxcarbazepine side effects include:

• Dizziness
• Sleepiness
• Double vision
• Tiredness
• Nausea
• Vomiting
• Problems with vision
• Trembling
• Problems with walking and coordination
• Rash

Be aware that there may be other, less common side effects you could experience. Always check the leaflet and discuss these risks with your doctor.

7. Levetiracetam

Brand names: Keppra, Keppra XR, Elepsia XR, spritam

Form: Comes as tablets or as a liquid

Treats: Juvenile myoclonic epilepsy, temporal lobe epilepsy, focal impaired awareness, myoclonic seizures, bilateral tonic-clonic seizure, focal aware onset seizure, tonic-clonic seizures. 

Levetiracetam is the generic name for Keppra and Spritam. It works by stabilizing electrical activity in the brain. 

Possible Levetiracetam side effects include: 

• Sleepiness
• Weakness
• Dizziness
• Infection

Be aware that there may be other, less common side effects you could experience. Always check the leaflet and discuss these risks with your doctor.

What if seizure medications don’t work?

Over the past century, scientists have discovered many powerful and effective ASMs which help many people lead seizure-free lives. These advances are great news for the epilepsy community as a whole. But many people who take ASMs find that they just don’t work for them - about one third of people have ‘refractory epilepsy’, which means they’ve tried two or more ASMs without being able to control their seizures.  

However, there are several alternative ways of treating epilepsy if ASMs don’t seem to work. These include special diets and medical devices. Learn more about alternative epilepsy treatment pathways in our blog. 

If anti-seizure medication is not working for you, speak with your doctor.