Neurology

Medicines for Epilepsy

A tendency to have recurrent seizures caused by bursts of abnormal electrical activity in the brain — controlled in most people with regular antiseizure medicine, with safety, pregnancy and driving rules central to care.

Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review

Quick answer

What is Epilepsy?

Epilepsy is a long-term condition in which a person has a lasting tendency to recurrent seizures — episodes caused by sudden, excessive electrical activity in the brain. Seizures take many forms: some involve loss of awareness and whole-body convulsions, while others are subtle, such as brief blank spells, unusual sensations, or jerking of one part of the body.

  • How it is treated: Epilepsy is usually managed by, or in close partnership with, a specialist.
  • Self-care: Regular sleep, limiting alcohol, taking medicine consistently and recognising personal triggers all help reduce seizures.
  • When to seek help: Call 999 if a convulsive seizure lasts more than five minutes, if one seizure follows another without recovery in between, if the person is injured, has trouble breathing, or it is their first ever seizure.

What it is

Epilepsy is a long-term condition in which a person has a lasting tendency to recurrent seizures — episodes caused by sudden, excessive electrical activity in the brain. Seizures take many forms: some involve loss of awareness and whole-body convulsions, while others are subtle, such as brief blank spells, unusual sensations, or jerking of one part of the body. Whether a seizure is "generalised" (involving both sides of the brain from the start) or "focal" (starting in one area) helps guide which treatment is most suitable. A diagnosis is usually made by a specialist after a careful description of the events, often supported by an EEG (a recording of the brain's electrical activity) and a brain scan. The aim of treatment is to allow people to live a full life with as few seizures as possible.

How it is treated

Epilepsy is usually managed by, or in close partnership with, a specialist. The goal is freedom from seizures on the lowest effective treatment, with the fewest side effects. Treatment normally begins with a single antiseizure medicine chosen to match the seizure type and the individual — including their age, other conditions and, very importantly, whether they could become pregnant. The medicine is built up gradually to find the level that controls seizures, and if the first choice does not work or is not tolerated, it is usually switched to an alternative before two medicines are combined. Antiseizure medicines should never be stopped suddenly, because abrupt withdrawal can trigger seizures, including prolonged ones. Because seizures can endanger the person and others, driving is governed by DVLA rules, which require a period free of seizures before driving may resume — your specialist will advise, and there is a legal duty to inform the DVLA.

For this condition, these medicines

Medicine classes used for Epilepsy

Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.

Lamotrigine Neurology A broad-spectrum first-line option suitable for many seizure types and often preferred where pregnancy is a consideration. Levetiracetam Neurology A broad-spectrum first-line option, widely used because it works for many seizure types and needs no routine blood-level checks. Sodium valproate Neurology Highly effective for several seizure types, but subject to strict pregnancy-prevention rules — it must not be used in anyone able to become pregnant unless stringent conditions are met, because it can seriously harm a baby in pregnancy. Carbamazepine Neurology A long-established option used particularly for focal seizures. Phenytoin Neurology An older medicine with a narrow margin between an effective and a toxic level, so it needs careful monitoring; used in selected situations. Gabapentinoids Neurology Used as an add-on treatment for focal seizures alongside another medicine.

Symptom checker

Symptoms that can point to Epilepsy

Epilepsy can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:

Seizures or fitsA sudden burst of abnormal electrical activity in the brain that can cause shaking, stiffe…

By active ingredient

Specific medicines used for Epilepsy

Dose-free guides to individual active ingredients used in epilepsy — what each is, how it works, how to take it, and its advantages and disadvantages:

GabapentinA medicine for nerve pain and epilepsy that calms over-excitable nerves — effective for ma…PregabalinA gabapentinoid for nerve pain, epilepsy and generalised anxiety that settles over-active …ClonazepamA benzodiazepine used to help control certain types of epilepsy; it can cause drowsiness a…ClobazamA benzodiazepine used mainly as an add-on treatment to help control epileptic seizures, wh…ZonisamideAn antiepileptic taken to help control seizures in epilepsy, often added to another medici…LacosamideAn anti-epileptic medicine used to help control focal (partial) seizures, on its own or wi…OxcarbazepineAn anti-epileptic medicine used to help control focal (partial) seizures, on its own or wi…PerampanelAn anti-epileptic medicine used, usually with other treatments, to help control focal and …BrivaracetamAn antiepileptic medicine used to help control certain types of seizure (focal/partial sei…EthosuximideAn anti-epileptic medicine used as a first-line treatment for absence seizures, mostly in …VigabatrinAn anti-epileptic used for infantile spasms and resistant focal epilepsy, with a serious r…CannabidiolA cannabis-derived medicine used to help control seizures in certain rare, severe epilepsi…CenobamateAn add-on epilepsy tablet used to help control focal seizures that have been hard to manag…FenfluramineAn add-on liquid medicine used to reduce seizures in rare, severe childhood epilepsies, gi…RufinamideAn add-on epilepsy medicine used to help control seizures in Lennox-Gastaut syndrome.…StiripentolAn add-on antiseizure medicine used, alongside other treatments, for a severe childhood ep…MidazolamA short-acting benzodiazepine used for sedation during procedures, to stop prolonged seizu…PhenobarbitalAn older barbiturate medicine used to control some types of seizure, including in babies, …EslicarbazepineAn antiepileptic medicine taken by mouth to help control focal seizures.…FelbamateA reserved, last-line antiepileptic used for severe epilepsy when other treatments have fa…PrimidoneAn older medicine used for some seizures and for essential tremor, which the body turns in…TopiramateA medicine used to help control epilepsy and to prevent migraine attacks.…FosphenytoinAn injectable medicine used in hospital for prolonged or repeated seizures, which the body…TiagabineAn antiepileptic medicine used alongside others to help control focal (partial) seizures.…EthotoinAn older anti-seizure medicine, related to phenytoin, that is now seldom used.…MesuximideAn older anti-epileptic from the succinimide family, used for absence seizures and now rar…ParamethadioneAn old antiepileptic once used for absence seizures, now obsolete because of serious side …PhensuximideAn older succinimide medicine once used to control absence (petit mal) seizures, now large…SultiameAn antiepileptic medicine used mainly for certain childhood focal epilepsies, such as beni…TrimethadioneAn obsolete older anti-seizure medicine once used for absence seizures, largely abandoned …Valproic acidA valproate medicine used to treat epilepsy and to stabilise mood in bipolar disorder, wit…CarbamazepineA long-established medicine for certain types of epilepsy and for trigeminal neuralgia (a …PhenytoinA long-established seizure medicine with a narrow safe range — small changes in the amount…Sodium valproateA broad-spectrum epilepsy medicine, also used in bipolar disorder — highly effective, but …LamotrigineA well-tolerated epilepsy medicine, also used to stabilise mood in bipolar disorder — intr…LevetiracetamA widely used, easy-to-start epilepsy medicine with few drug interactions — effective acro…

Beyond medication

Lifestyle and self-care

Regular sleep, limiting alcohol, taking medicine consistently and recognising personal triggers all help reduce seizures. Practical safety measures, awareness of swimming and bathing risks, and informing the DVLA are part of living well with epilepsy. Anyone planning a pregnancy should seek specialist advice well in advance, as some medicines are unsafe in pregnancy.

When to get help

When to see a doctor

Call 999 if a convulsive seizure lasts more than five minutes, if one seizure follows another without recovery in between, if the person is injured, has trouble breathing, or it is their first ever seizure. Seek prompt advice for more frequent seizures, troubling side effects, or before any change to medicine — and never stop antiseizure medicine suddenly.

999Emergency — call 999 or go to A&E
111Urgent advice — call NHS 111 or use 111 online
GPNon-urgent — see your GP or pharmacist

Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.

Answers

Epilepsy: frequently asked questions

What medicines are used for epilepsy?

Common first-line, broad-spectrum options include lamotrigine and levetiracetam. Sodium valproate is very effective but carries strict pregnancy-prevention rules. Carbamazepine is often used for focal seizures, phenytoin is an older option needing careful monitoring, and gabapentinoids may be added on for focal seizures. The right choice depends on your seizure type, age, other conditions and whether you could become pregnant.

Why is sodium valproate restricted in women and girls?

Taken during pregnancy, sodium valproate can cause serious birth defects and lasting problems with a child's development. Because of this, it must not be used in anyone able to become pregnant unless stringent conditions of a pregnancy-prevention programme are met. If you take it and might become pregnant, speak to your specialist — but never stop it suddenly yourself, as that can trigger seizures.

Can I drive if I have epilepsy?

It depends on your seizures. The DVLA sets out how long you must be free of seizures before you may drive again, and you have a legal duty to inform them about your condition. Your specialist will advise on the rules that apply to you. Driving against this guidance is dangerous and unlawful.

Can I stop my epilepsy medicine once seizures stop?

Possibly, after a sustained seizure-free period, but only under specialist guidance and never abruptly. Stopping suddenly can provoke seizures, including prolonged ones. Any reduction is planned carefully, weighing the chance of seizures returning against the benefits of coming off treatment.

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Sources

Where this is drawn from

  • NICE NG217: Epilepsies in children, young people and adults.
  • NICE CKS: Epilepsy.

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