Epilepsy is treated with anti-seizure medications chosen for the seizure type and the individual. The principle is one drug at the lowest effective dose where possible, increased gradually, with most people achieving good control on the first or second agent tried. Missed doses are among the commonest causes of breakthrough seizures, and no anti-seizure medication should ever be stopped abruptly.
Epilepsy is treated with anti-seizure medications chosen for the seizure type and the individual. The principle is one drug at the lowest effective dose where possible, increased gradually, with most people achieving good control on the first or second agent tried. Missed doses are among the commonest causes of breakthrough seizures, and no anti-seizure medication should ever be stopped abruptly.
Seizure type comes first, because a drug that suits focal seizures may worsen certain generalised types. Beyond that, the decision weighs your other medical conditions, your other medications, your age, and whether pregnancy is a consideration. Commonly used agents include levetiracetam, lamotrigine, valproate, carbamazepine and oxcarbazepine, among others. Valproate carries significant risks in pregnancy and is avoided where pregnancy is possible unless there is no reasonable alternative.
Medication is started at a low dose and increased in steps, because starting high causes side effects that end the trial before benefit appears. Several visits of adjustment is the normal course. Some drugs need blood level or laboratory monitoring; others do not. Side effects are part of the assessment rather than an afterthought, since the aim is no seizures with effects you can live with, and quietly stopping because of side effects is considerably more dangerous than reporting them.
Missed doses are among the commonest causes of breakthrough seizures, so a routine that makes missing one unlikely is part of the treatment. Never stop an anti-seizure medication abruptly, since that can provoke prolonged seizures. Interactions matter considerably, including with hormonal contraception in both directions, so any new prescription should be checked against your anti-seizure medication rather than assumed compatible.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: epilepsy; American Academy of Neurology; National Institute of Neurological Disorders and Stroke.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.