In the past several years, newer medications for epilepsy has flooded the pharmacy shelves.
Oxarbazepine (Trileptal). It is indicated for partial seizures and does not need routine monitoring of blood level. Sedation is its primary side effect.
Lamotrigine (Lamictal). It is a broad spectrum medicine for seizure disorders. It requires slow titration or increases to reach a final dose. Rashes that can be serious, although rare, is a side effect.
Levetiracetam (Keppra). This is also a broad spectrum medicine for seizure like Lomotrigine. However, its dose can be increased faster. Some patients can have some “behavioral reactions.” Blood test is not needed for monitoring.
Topiramate (Topamax). This is the third broad spectrum medicine for epilepsy. Cognitive impairement is possible at higher doses. Poor appetite, kidney stones, glaucoma, and acidosis have been reported with this medication.
Zonisamide (Zonegran). Also a broad spectrum drug for epilepsy. Like Topiramate, it is a second line use. It can cause kidney stone, oligohidrosis, and hyperthermia (high temperature.)
These newer medications should be used with the help of a Pediatric Neurologist.
The risk-benefit ratio should be explained to the parents before any medications is prescribed.
Leo Leonidas, MD, FAAP