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Seizure Medications: Keppra, Topamax, Depakote, & Lamictal

Updated on March 14, 2011

Types of Seizure Medications

There are various different medications that one can take for seizures, but before choosing which is the best for you or your child, talk to you neurologist first.

Below are some of the more commonly prescribed medications for patients who suffer seizures or epilepsy.

Note: my son has partial seizures and has had one or two grand mal seizures in the past. The following four medications are those that my wife and I have tried in the past or currently have him on.

Currently, my son is on, Topomax, Depakote, and Lamictal. We took him off of Keppra because of extreme mood swings and occasional aggressive behaviors.

This and other information can be found at Merck.

Keppra (Levitiracetum)

Keppra

(caused mood swings and aggressive behavior in my son)

Symptoms that indicate use: Partial onset seizures

Symptoms that indicate not using: Hypersensitivity

Metabolism: 66% excreted unchanged by the kidneys; some metabolism by the liver

Use Cautiously in:

  • Lactaction.
  • Renal elimination decreased in geriatric patients
  • Renal impairment (dose reduction recommended if CCr < 80 ml/minr.)
  • Children under 4 years
  • Use only during pregnancy if potential benefits justifies potential risk to fetus.

Potential Side Effects:

dizziness, fatigue, weakness, behavioral abnormalities, coordination difficulties (adults only)

 

Topamax (Topiramate)

Topamax

(increased Tonic Seizures, and some Status Epilepticus Seizures for my son.)

Symptoms that indicate use:

  • Seizures including, partial-onset, primary generalized tonic-clonic, seizures due to Lennox-Gastaut syndrome.
  • Prevention of migraine headace in adults.

Symptoms that indicate not using:

  • Hypersensitivity
  • OB: Lactaction.

Metabolism: 70% is excreted unchanged in urine

Use Cautiously in:

  • Renal impairment
  • Hepatic impairment.
  • In geriatric patients, consider age-related decrease in renal/hepatic impairment, concurrent disease states, and drug therapy.
  • Children are more prone to oligohydrosis and hyperthermia; use with caution with children under 2 yrs.
  • Dehydration
  • Pregnancy (use only if maternal benefit outweighs fetal risk).

Potential Side Effects:

increased seizures, dizziness, drowsiness, fatigue, impaired concentration/memory, nervousness, psychomotor slowing, speech problems, aggressive reaction, agitation, anxiety, cognitive disorders, confusion, depression, malaise, mood problems, abnomal vision, diplopia, nystagmus, acute myopia/secondary angle closure glaucoma, nausea, abdominal pain, anorexia, constipation, dry mouth, kidney stones, oligohydrosis (increased in children), hyperchloremic metabolic acidosis, leukopenia, weight loss, hyperthermia (increased in children), ataxia, paresthesia, tremor, suicide attempt, fever

 

Depakote (Divalproex Sodium)

Depakote

(My son uses in combination with Lamictal)

Symptoms that indicate use:

  • Simple and complex absence seizures
  • Partial seizures with complex symptomatology

Symptoms that indicate not using:

  • Hypersensitivity
  • Hepatic impairment.
  • Some products contain tartrazinel avoid in patients with known hypersensitivity.
  • Suspected urea cycle disorders (may result in fatal hyperammonemic encephalopathy)

Metabolism: Mostly metabolized by the liver; minimal amounts excreted unchanged in urine

Use Cautiously in:

  • Bleeding disorders
  • History of liver disease
  • Organic brain disease
  • Bone marrow depression
  • Renal impairment
  • Children, especially under 2 years, are at increased risk for potentially fatal hepatotoxicity.
  • Use during pregnancy is linked to developmental defects, low IQ, birth defects, congenital anomalies, and hepatic dysfunction in the neonate. Use with extreme caution.
  • Lactation: Valproates pass into breast milk. Consider discontinuing nursing when valproates are administered to the nursing mother.

Potential Side Effects::

confusion, dizziness, headache, sedation, visual disturbances, hepatotoxicity, indegestion, nausea, vomiting, anorexia, constipation, diarrhea, hypersalivation, increased appetite, Pancreatitis, rashes, leukopenia, prolonged bleeding time, thrombocytopenia, hyperammonemia, ataxia, paresthesia

Lamictal (Lamotrigine)

Lamictal

(My son uses in combination with Depakote)

Symptoms that indicate use:

  • Adjunct treatment of partial seizures in adults with epilepsy.
  • Lennox-Gastaut syndrome.
  • Conversion to monotherapy in adults with partial seizures receiving a single enzyme-inducing antiepileptic drug.
  • Maintenance treatment of bipolar disorder.

Symptoms that indicate not using:

  • Hypersensitivity
  • Lactation

Metabolism: Mostly metabolized by the liver to inactive metabolites; 10% excreted unchanged by the kidneys.

Use Cautiously in:

  • Reduced renal function.
  • Cardiac function impairment.
  • Hepatic function impairment.
  • Pregnancy or children.
  • Prior history of rash to lamotrigine.

Potential Side Effects:

ataxia, dizziness, headache, behavior changes, depression, drowsiness, insomnia, tremor, blurred vision, double vision, rhinitis, nausea, vomiting, vaginitis, photosensitivity, rash (higher incidence in children, patients taking VPA, high initial doses, or rapid dosage increases), arthralgia, allergic reactions including Stevens-Johnson syndrome

Disclaimer

I am not a doctor, physician, or specialist. The information that I have provided is from personal research. For more information, always ask your neurologist for help.

Comments

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    • profile image

      Rebecca K 

      8 years ago

      I am currently writing a series related to my experience with a brain tumor which led to Absent Seizures for me. I had successful removal of the tumor 4 months ago and have removed myself from all medications (Keppra), but still have severe low back pain that I did not have prior. I was wondering if your son or anyone who reads this may have noticed similar... Thanks, Rebecca

    • profile image

      Katie B 

      8 years ago

      Our 4 year old son has Atypical Absence. Has been on Lamictal with success (3 or 4 seizures a day comapared to hundreds a day before). Added Keppra which caused spikes in seizures. Zonegran, which made him unable to speak. Finally, depakote, which has increased his number of seizures. Anyone else heard of this happening? We are thinking of goin back to Lamictal only, since he had 2-3 seizures a day.

    • Michael Shane profile image

      Michael Shane 

      8 years ago from Gadsden, Alabama

      I have taken everything from phenobarbital (Bad effects), dilantin, depakote, depakene, tegretol, topamax, nuerontin, and so many others from the age of 10 for onset partial seizures due to a childhood stroke I recently found out in a MRI 6 years ago. Not one medication ever stopped the seizures except the one I came across a year ago, Keppra is my wonder pill! It's too bad it didn't work for him. The only allergic reactions I had was with dilantin & tegretol. The rest of just made me feel doped up but did not help at all. Everybody reacts different to medications & you just have to keep searching for the right one. The best tip is lifestyle routines. Be careful with bright lights, too much t.v., game systems, computer use, and eat & sleep properly..Life is harder but you have to train yourself to take deep breaths & search for inspiration...Great Hub!

    • Ann Nonymous profile image

      Ann Nonymous 

      8 years ago from Virginia

      I was wondering if you have ever heard or been warned that Topamax can cause or lead to anorexia? I looked up the side effects on Topamax's website but there wasn't anything said about it...However I was reading about the Ketogenics diet and in one particular book it was mentioned that it is best to be "weaned off Topamax" due to it causing weight loss and anorexia...What are your thoughts on this?

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