Epilepsy is usually managed through medication. There are two main types of medication that you might be prescribed to manage your condition, regular (maintenance) and emergency (rescue) medication. You can find out about drugs that you might be prescribed below:

Regular Medication
Maintenance medication is used to try and prevent seizures; this medication is known as antiepileptic drugs or AEDs. It is usually introduced at a low dose and gradually increased, over a period of weeks, to the dose that your doctor thinks is right for you, this is done to reduce the risk of any side effects. It is very important that you follow the instructions given by your doctor.

The most commonly prescribed antiepileptic drugs are carbamazepine, lamotrigine, levetiracetam and sodium valproate. Others you may know about can include brivaracetam, clobazam, clonazepam, ethosuximide, lacosamide, oxcarbazepine, perampanel, phenobarbitone, phenytoin, rufinamide, stiripentol, tiagabine, topiamate, vigabatrin, zonisamide. You can find out more about the specific medicines here.

It is important that you do not stop taking antiepileptic medication except on the advice of the doctor managing your epilepsy. Stopping medication suddenly may cause a seizure (even if you have not had one for a long time) or other withdrawal effects. If your doctor feels that you are ready to come off your medication, they will give you instructions for reducing the dose gradually.

It is very important that you always take your medication as prescribed, and at roughly the same time(s) each day, because if you miss doses you are more likely to have seizures. If you realise that you have forgotten to take your medication please refer to the patient information leaflet that came with it. If you don't have the leaflet and you normally take medication twice a day:

• if it is less than four hours since you should have had it, then take it immediately and take the next dose at the usual time
• if it is more than four hours after you should have had it, then miss that dose, but make sure that you take the next dose on time.
• if you normally take your medication once a day then you can take it up to 12 hours after the time you would normally take it.
• if you are unsure whether to take it or not, please consult your doctor, pharmacist or epilepsy nurse straightaway.

Side effects:
You may experience side effects from the medication. Side effects are often temporary, wearing off after a number of weeks, but may come back for a short time if the dose is increased. However, many people do not have any side effects at all. If you are concerned that you may be having unwanted effects from your medication please talk to your doctor or epilepsy nurse about it. If you feel unwell and develop a rash whilst taking medication inform your doctor immediately, as occasionally a rash may be the sign of a serious condition.

Emergency Medication
Some people with epilepsy experience seizures despite taking regular medication. Sometimes these may be what are referred to as prolonged seizures. This means that they last longer than 5 minutes. If you have previously had one or more prolonged tonic-clonic seizures, or clusters of lots of seizures, your doctor may prescribe some medication known as emergency or rescue medication.

Emergency medication is given to someone with epilepsy during a seizure to stop it before it goes on too long. There are 3 different forms of emergency medication and they all take 5-10 minutes to stop a seizure.

Buccal midazolam is the most commonly used. This is a liquid that is squirted into the side of the mouth during a seizure. It does not need to be swallowed as it works by being absorbed through the gums and inside of the cheek. Some people may need a second dose to stop the seizure.

Rectal diazepam is also a small amount of liquid medicine that is given into the rectum (back passage) during a seizure.  Some people may need a second dose to stop the seizure.

Rectal paraldehyde is also a liquid that is inserted into the rectum during a seizure.