Epilepsy can be a complex disorder.

About Epilepsy and its Treatment

For most people diagnosed with epilepsy, becoming seizure free is the goal.

Work with your healthcare professional to begin treatment as soon as possible. Some basic questions about epilepsy and its treatment are answered below.

What is epilepsy?
Epilepsy is a brain disorder in which a person is prone to having recurring seizures. A seizure happens when the way in which the nerve cells in your brain send electrical signals becomes disturbed. These disturbances can interfere with your senses, your awareness of things around you, and the way your body moves. During a seizure, the nerve cells in your brain may fire together and much more frequently than usual. ^ Return To Top
Are there different types of seizures?
Yes. There are a number of different types of seizures. They differ in many ways, including their outward form and the way they make you feel. Some people may experience only one type of seizure; others may experience more than one. Most epileptic seizures are either partial seizures (also called focal seizures), which affect just one part of the brain, or generalized seizures, which affect both sides of the brain at the same time. See our Types of Seizures page for more. ^ Return To Top
What causes epilepsy?
In most people there is no known specific cause of epilepsy. In others, an accident, trauma, or illness (such as a tumor, stroke, or infection) that injures the brain may be a cause. Sometimes epilepsy can be inherited. ^ Return To Top
Are seizures dangerous?
If not controlled with proper medication, seizures can be dangerous or even life-threatening. Even when seizures are brief and infrequent, they are not harmless if they disrupt your life or put you and others at risk of being injured. ^ Return To Top
Does epilepsy get worse as you get older?
Not usually. Epilepsy is not a condition that gets more severe the longer you live with it. In fact, with the right treatment, most people can bring their seizures under control. ^ Return To Top
How is epilepsy treated?
The primary treatment for epilepsy is the use of antiseizure medicines—called anticonvulsants or antiepileptic drugs—to bring seizures under control. The goal is to prevent seizures while minimizing side effects from the drugs. If medicines fail to control your seizures, other treatment options may be available. Work with your healthcare professional to make sure your treatment is as effective as possible. ^ Return To Top
Can medicines cure epilepsy?
Antiseizure medicines can reduce the occurrence of seizures or prevent them from occurring, but they do not cure epilepsy. In some people, over time, seizures do disappear. This is more likely when treatment has brought the epilepsy under control. ^ Return To Top
Are there dietary or herbal alternatives to antiepileptic drugs?
The ketogenic diet—a restricted diet that is high in fats and low in carbohydrates—is sometimes used to treat children with severe seizures that cannot be controlled with drugs alone. This treatment is not without risks; it can cause kidney stones and high cholesterol.

No herbal or nutritional supplement has been proven to control seizures. In fact, some herbals can actually trigger seizures. Talk with your healthcare professional about any dietary or herbal agents you may be taking: such supplements could affect your medicine’s effectiveness, cause side effects, or increase the frequency of your seizures. ^ Return To Top
What are side effects?
Even well-tolerated medicines can have unwanted additional actions—side effects—alongside their helpful actions. For instance, some medicines may make you feel dizzy, tired, or sleepy. A side effect may be absent or hardly noticeable for one person but heightened for another.

Side effects are most likely to appear when your body is just getting used to a new medicine. Your healthcare professional can help to guide you through this period and explain what you can do to reduce the impact of any side effects you experience. ^ Return To Top
What is the right treatment for me?
Many different drugs are available for the treatment of epilepsy. Sometimes the first medicine you try will be all that is needed to control your seizures. However, since everyone is different, it may take several tries to find the single drug or combination of drugs that works best for you. Only you and your healthcare professional will be able to decide which treatment is right for you. ^ Return To Top
Where can I get answers to my other questions?
Your physician should be your primary source for all medical questions. For practical answers, get in touch with other people who are living with epilepsy, and learn about what has worked for them. Online communities and local organizations are a good place to start. Please see Important Organizations and Resources for more.

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About TOPAMAX®

TOPAMAX® is approved as initial monotherapy in patients 2 years of age and older with partial-onset or primary generalized tonic-clonic seizures.

Safety and effectiveness in patients who were converted to monotherapy from a previous regimen of other anticonvulsant drugs have not been established in controlled trials.

TOPAMAX® is approved as add-on therapy for patients 2 years of age and older with primary generalized tonic-clonic seizures, partial-onset seizures, or seizures associated with Lennox-Gastaut syndrome.

Important Safety Information

Warnings and Precautions

TOPAMAX® may cause eye problems. Serious eye problems include: sudden decrease in vision with or without eye pain and redness; blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma). These eye problems can lead to permanent loss of vision if not treated. You should call your healthcare professional right away if you have any new eye symptoms.

TOPAMAX® may cause decreased sweating and increased body temperature (fever). People, especially children, should be watched for signs of decreased sweating and fever, especially in hot temperatures. Some people may need to be hospitalized for this condition. Call your healthcare provider right away if you have a high or persistent fever or decreased sweating.

TOPAMAX® can increase the level of acid in your blood (metabolic acidosis). If left untreated, metabolic acidosis can cause brittle or soft bones (osteoporosis, osteomalacia, osteopenia), kidney stones, can slow the rate of growth in children, and may possibly harm your baby if you are pregnant. Metabolic acidosis can happen with or without symptoms. Sometimes people with metabolic acidosis will: feel tired, not feel hungry (loss of appetite), feel changes in heartbeat, or have trouble thinking clearly. Your healthcare provider should do a blood test to measure the level of acid in your blood before and during your treatment with TOPAMAX®. If you are pregnant, you should talk to your healthcare provider about whether you have metabolic acidosis.

Like other antiepileptic drugs, TOPAMAX® may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. Pay attention to any changes and call your doctor right away if you have any of these symptoms, especially if they are new, worse, or worry you: thoughts about suicide or dying, attempts to commit suicide, new or worse depression, new or worse anxiety, feeling agitated or restless, panic attacks, trouble sleeping (insomnia), new or worse irritability, acting aggressive, being angry or violent, acting on dangerous impulses, an extreme increase in activity and talking (mania), or other unusual changes in behavior or mood.

TOPAMAX® may affect how you think, and cause confusion, problems with concentration, attention, memory, or speech, depression or mood problems, tiredness, and sleepiness.

Do not stop taking TOPAMAX® without first talking to your doctor. Stopping TOPAMAX® suddenly can cause serious problems.

If you take TOPAMAX® during pregnancy, your baby has a higher risk for birth defects called cleft lip and cleft palate. These defects can begin early in pregnancy, even before you know you are pregnant. There may be other medicines to treat your condition that have a lower chance of birth defects. All women of childbearing age should talk to their healthcare providers about using other possible treatments instead of TOPAMAX®. If the decision is made to use TOPAMAX®, you should use effective birth control (contraception) unless you are planning to become pregnant. Tell your healthcare provider right away if you become pregnant while taking TOPAMAX®. You and your healthcare provider should decide if you will continue to take TOPAMAX® while you are pregnant. Metabolic acidosis may have harmful effects on your baby. Talk to your healthcare provider if TOPAMAX® has caused metabolic acidosis during your pregnancy. If you become pregnant while taking TOPAMAX®, talk to your healthcare provider about registering with the North American Antiepileptic Drug Pregnancy Registry. You can enroll in this registry by calling 1-888-233-2334. The purpose of this registry is to collect information about the safety of antiepileptic drugs during pregnancy.

TOPAMAX® may cause high blood ammonia levels. High ammonia in the blood can affect your mental activities, slow your alertness, make you feel tired, or cause vomiting.

Taking TOPAMAX® when you are also taking valproic acid can cause a drop in body temperature (hypothermia) to less than 95ºF, feeling tired, confusion, or coma.

Adverse Reactions

As monotherapy, the most common side effects of TOPAMAX® (in the 400 mg/day group and at a higher rate, ≥ 5%, than the 50 mg/day group) in adults were tingling in arms and legs, weight decrease, loss of appetite, sleepiness, and difficulty with memory; and in children, fever, weight decrease, mood problems, cognitive problems, infection, flushing, and tingling in arms and legs.

In combination with other antiepileptic drugs (AEDs), the most common side effects of TOPAMAX® in adults (200 to 400 mg/day) were sleepiness, dizziness, loss of muscle coordination, speech disorders and related problems, psychomotor slowing, abnormal vision, difficulty with memory, tingling in arms and legs, and double vision; and in children (5 to 9 mg/kg/day), fatigue, sleepiness, loss of appetite, nervousness, difficulty with concentration/attention, difficulty with memory, aggressive reaction, and weight decrease.

Tell your doctor about other medications that you are taking. Report any side effect that bothers you or that does not go away.

These are not all the possible side effects of TOPAMAX®. For more information, ask your healthcare professional or pharmacist.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see full US Prescribing Information and Medication Guide.

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This site was last modified on: Sep 14 2012 at 08:06:17 EST