Epilepsy treatment: clear options, meds, and what to do

If you or someone you care for has epilepsy, the goal is simple: reduce seizures and keep daily life normal. That usually means finding the right anti-seizure medication, making lifestyle changes that lower triggers, and knowing exactly what to do during a seizure. Below you’ll find clear, practical options and steps you can use today.

Common medications and how they work

Doctors usually start with a single anti-seizure drug and adjust from there. Common options include levetiracetam (Keppra), lamotrigine (Lamictal), valproate (Depakote), carbamazepine (Tegretol), and phenytoin. Each works differently to calm overactive brain activity. Some meds suit focal seizures better, others help generalized seizures.

Expect a bit of trial and error. Finding the right dose can take weeks. Keep a seizure diary so your doctor can see patterns. Report side effects—dizziness, mood changes, or rashes—right away. Never stop a drug suddenly; that can trigger more seizures.

When meds aren't enough — other treatments

If seizures continue despite two well-chosen drugs, ask about other proven options. Epilepsy surgery can remove the seizure focus for select patients and can be curative. Vagus nerve stimulation (VNS) and responsive neurostimulation (RNS) help reduce seizure frequency for people who aren’t surgery candidates. The ketogenic diet—high fat, low carb—still helps some children and adults when closely supervised.

CBD (prescription cannabidiol) is approved for certain severe epilepsy types. Talk to your neurologist about risks and interactions with other meds.

Practical daily tips: get regular sleep, avoid heavy alcohol use, follow medication schedules precisely, and manage stress. Check labels for drug interactions—some antibiotics, herbal products, and hormonal contraceptives change how anti-seizure drugs work.

Seizure first-aid everyone should know: stay calm, time the seizure, protect the person from injury (move sharp objects away), cushion the head, and roll them onto their side if possible. Do NOT put anything in the mouth or try to restrain movements. Call emergency services if the seizure lasts more than 5 minutes, if another seizure follows right away, if the person remains unconscious, or if it’s their first seizure.

Work with your care team to build a seizure action plan that lists medications, emergency contacts, and specific steps for different seizure types. Ask about driving rules where you live—restrictions often apply after recent seizures.

Small changes add up: a consistent bedtime, medication reminders, and a clear plan for emergencies make life safer and more predictable. If seizures continue despite treatment, get a second opinion at an epilepsy center—specialists there have more tools to help.

Got questions about a specific drug, surgery, or lifestyle tweak? Talk to your neurologist or epilepsy nurse. They can tailor the plan to your type of seizures and daily life.