Seizure control with ASMs

Just as every epilepsy diagnosis is different, so is the treatment. And anti-seizure medication (ASMs) (previously known as anti-epileptic drugs (AEDs) are no exception. But with so many options available you can forgive yourself for asking ‘which are the right ASMs for me and what risks come with them?’. You’re used to medical jargon. You’re fluent in a lot of it. But when it comes to your meds you need clarity not second-guessing. So, let’s take a look in more detail.

What do ASMs control?

ASMs treat seizures. They don’t cure your epilepsy but they can reduce seizures in 70% of people. How? ASMs change the balance of chemicals in your brain to control your epilepsy. It sounds simple but your choice of ASMs depends on your circumstances greatly. However, there’s also a risk they may stop working after a while. Your epilepsy doctor has lots to consider before prescribing an ASM for you to try – including:

  • Your age
  • The type of seizures you have
  • How often you have a seizure
  • Your lifestyle
  • Your gender – if you’re female, ASMs can harm an unborn baby, so fertility is something to consider if you’re planning on having a child
  • Contraception – if you’re taking the ‘Pill’ most ASMs will stop this working and there’s a risk they can affect the success of IUD and contraceptive injection too
  • Other conditions and medication - ASMs can interfere with other medication, for example anti-depressants or meds for associated conditions such as cerebral palsy
  • Timing - this plays a vital role with ASMs. You have to be consistent when you take your meds for them to work successfully so your epilepsy doctor will discuss lifestyle and routines with you
What types of ASMs are available?

ASMs can be divided in to two categories: narrow-spectrum ASMs and broad-spectrum ASMs. Depending on your epilepsy, you may need to take more than one type. According to the National Institute of Neurological Disorders and Stroke there’s more than 20 ASMs available on prescription in the UK. All need to be taken daily and many are available in a variety of forms including tablets, capsules, liquids and syrups, common types include:

  • Sodium valproate 
  • Lamotrigine 
  • Carbamazepine
  • Levetiracetam
  • Oxcarbazepine
  • Ethosuximide
  • Topiramate

Your epilepsy doctor will usually prescribe a low dose to begin with and gradually increase this until your seizures stop. Of course, there’s no guarantee that the ASM will suit you, so you may need to try different treatments and work with your doctor to find the one that suits you best. Depending on which meds you’re prescribed you may need to stop taking certain over-the-counter meds or complimentary medicines as these could affect the success of your ASM. If you have any concerns, chat to your epilepsy doctor to answer your queries.


What are the side-effects?

Like all medications, ASMs carry a list of potential side-effects. Don’t ignore them but at the same point don’t convince your self that they’ll happen. Just keep them on your radar so that you can use them as an indication of whether your meds suit your body or not. Some side-effects can happen quickly, others may present themselves after a few weeks. Common side-effects from ASMs include:

  • Agitation
  • Drowsiness
  • Lack of energy
  • Headaches
  • Hair loss or unwanted hair growth
  • Rashes
  • Swollen gums
  • Tremors or uncontrollable shaking


If you experience any of the above, contact your epilepsy doctor immediately. If your symptoms include vomiting, unsteadiness, poor concentration or dizziness you should also seek urgent medical advice as it could be that your dosage is too high.

Challenge your clinician

The most important thing to remember is that your epilepsy doctor is working with you to find the medication that best suits your body. And you know your body better than anyone, so keep them up to date with the slightest development or concern you have with your ASMs. Just as your epilepsy doctor has lots to consider, so do you. It’s important you have the confidence to challenge their prescription. If you’ve had two failed ASM trials you’re within your rights to consider non-drug related interventions. Chat to your epilepsy doctor honestly about your concerns and hopes with your meds – they’re on your side and are there to support you.

How risky are ASMs?

Different drug manufacturers’ products vary considerably in their characteristics.  So even though the ASM is technically the same, switching to a different provider could cause adverse effects or reduce your seizure control. Depending on the meds you’re prescribed, your pharmacist or epilepsy doctor may insist that your ASMs are always provided by the same manufacturer. To help healthcare professionals decide how to maintain a continuous supply of certain products, ASMs have been divided into three risk-based categories. You won’t be expected to have in-depth knowledge about this - your epilepsy doctor will guide you through it all. But if you want to know more, we want you to find everything you need on The Channel. If you still have unanswered questions let us know. 

And don’t forget – your body is unique. There are no hard and fast rules when it comes to finding the meds that suit you best – you know it comes down to patience, perseverance and trust in the medical professionals in your team. Just like you, we hope your ASMs give you back the control to live your life the way you want to live it. And if yours have – get in touch, your experience could help someone else find the balance they need.