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When and how to stop antiseizure medicines
HealthWiki > Epilepsy and Seizures > Chapter 4: Medicines for epilepsy and seizures > When and how to stop antiseizure medicines
When to stop antiseizure medicines
Many people with epilepsy wonder: If I have not been having seizures for some time, does this mean I can stop taking medicine?
There is no answer to this question that is correct for everyone. Whether someone can stop medicine depends on their type of epilepsy, if they are taking one or more medicines, how easy or difficult it has been to control their seizures with medicine, and if seizures came back when they tried to stop using medicine before.
Certain epilepsy syndromes, such as Lennox-Gastaut syndrome, require a person to take medicine for their entire life. Some seizure types, such as myoclonic seizures in children, are likely to require ongoing treatment with medicine so that seizures are controlled. But for other epilepsies, medicine may not be needed forever, although in many cases, they are.
If you are thinking about stopping antiseizure medicine, it is very important to get help from a doctor or other health worker. Together, you can decide if the benefit (positive) of stopping the antiseizure medicine is greater than the harm (negative) that a seizure may happen again. A doctor or health workerâs role is to share information, answer questions, and listen carefully to support you in the process of making a decision. The decision to stop or continue taking medicine is yours, but stopping medicine suddenly and without advice and guidance can be dangerous. Your seizures might restart immediately.
Another commonly-asked question is: How long should I not have seizures before thinking about stopping epilepsy medicine?
Research and medical practice around this topic (called âseizure freedomâ) have been changing. Some studies and doctors suggest that stopping medicine may be possible if a person has no seizures for 2 to 3 years while on medicine. However, other studies show that waiting at least 5 years without seizures while on medicine may be safer and may reduce the chances of seizures returning.
For any person with epilepsy taking daily antiseizure medicine, stopping medicine means freedom from side effects and an end to a dependency on medicine, which are concerns for many people. However, it also means living with uncertainty about having another seizureâtaking antiseizure medicine offers emotional security as well as protection against seizures.
If seizures happen again after stopping medicine, it means that epilepsy is still present. The chances of seizures happening after stopping medicine are highest during the first year after stopping, especially the first 6 to 12 months. However, for some types of epilepsy, the risk that seizures may return can last several years. It can help to discuss your situation with a doctor or other health worker.
How to stop taking medicine
Just as the body gets used to taking antiseizure medicine every day, it will need some time to get used to not taking medicine. Ask your health worker about how much time you will need and what changes in the body you can expect as you slowly lower your dose of medicine.
Slow stopping of medicine is considered safest. Sudden withdrawal can increase the possibility, intensity, and frequency of seizures happening again. Stopping medicine suddenly is also associated with higher risk of death from seizures since it can cause rare cases of status epilepticus. It can also increase seizure frequency, a key risk factor for SUDEP (sudden unexpected death in epilepsy). See more about status epilepticus and SUDEP.
To stop antiseizure medicine, slowly reduce the dose over 2 to 3 months, or even longer. The amount of time needed to stop taking medicine safely is different for each person, depending on their epilepsy and on what medicine they are taking. If a combination of medicines is being stopped, the process may take longer since each medicine will need to be slowly stopped, one at a time.
If seizures happen again after stopping medicine, the person probably needs to start taking medicine again to bring their seizures back under control.