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The past two decades have seen a host of new anti-epileptic drugs come on the market. While these new drugs aren’t able to eliminate seizures in all children, they do give us new options to try when first-line drugs aren’t working. Many of the new drugs work through completely different mechanisms, giving new strategies to control seizures, often with fewer side effects.
Some of the medications in the chart below are not yet FDA-approved for children but are often used at Boston Children’s Hospital. Two additional medications not on the chart, stiripentol (Diacomit®) and sulthiame (Ospolot®), are not yet commercially available in the United States but can be made available to some children with specific types of epilepsies.
Compared to the pre-1990 drugs, many of the newer drugs have a broader range of action, making them more likely to work for generalized seizures. However, some of them, like gabapentin, pregabalin, oxcarbazepine and tiagabine, seem to work only for seizures that have a focal onset.
The newer drugs tend to be less sedating, have fewer adverse effects on memory and learning, and are less likely to cause allergic reactions and serious side effects. But there are still some exceptions to be aware of:
Another benefit of the newer drugs is that they tend not to interact with other medications or each other. However, some of the older drugs do affect the metabolism of some of the newer drugs.
Unfortunately, even with all these new medications, some children still have seizures that remain difficult to control. Recently, however, research findings have created new opportunities to fine-tune and individualize medical treatment to help control seizures. Possible options include:
If your child has seizures that aren’t controlled well by medications, you may want to explore some of these options with your care team. Your child may be eligible for one of our ongoing research studies that are investigating these new treatment approaches.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”