LeBron Paige, M.D.
LeBron Paige, M.D., is an assistant professor of neurology at the University of Alabama at Birmingham’s Level 4 Epilepsy Center. He specializes in the medical and surgical management of epilepsy, and is studying cutting-edge imaging techniques and devices that pinpoint the area within the brain where seizures arise.*
Should I Ever Stop Taking My AEDs?
Treating epilepsy is a dynamic process that can and should change, depending on where you are in life and what else is going on in your medical picture. For example, some children with particular types of epilepsy can “outgrow” seizures. At the other end of the spectrum, older adults may need to reduce or switch medications as their health and body change.
Patients can have withdrawal seizures if medications aren’t tapered slowly and appropriately. This isn’t related to their epilepsy but to their brain having adapted to need that medication. This is especially common with drugs such as phenobarbital, Klonopin and Ativan—drugs that may cause drowsiness. So it’s very important that tapering is closely supervised by a doctor with expertise in the medical management of epilepsy.
Some people experience less serious withdrawal symptoms. They may feel anxious, jittery, tingly or just not quite right. Sometimes this feels a lot like a prelude to a seizure. Withdrawal symptoms typically last a week or two, and rarely up to a month. Tell your doctor about any symptoms right away.
As patients get older, their bodies change: kidney and liver function can diminish, and the ability to tolerate side effects may decline. Often they experience changes in their sleep habits or metabolism. Also, older adults tend to take drugs for other conditions, and those medications can interact with their seizure medications.
Your doctors can work with you to choose medications that will mediate potential side effects. Some may need a lower dose of a medication they’re already taking.
Your doctors can work with you to choose medications that will mediate potential side effects. Some may need a lower dose of a medication they’re already taking.
People at any stage of life can experience “idiopathic changes,” with idiopathic meaning we don’t know what the cause is. These are changes that just happen—a drug or drug combination that’s been controlling a person’s seizures can suddenly stop working or start producing new, uncomfortable side effects. Both these things can change without warning even when people have been taking their medication without problems for long periods.
If this happens, people need to work closely with their doctors to find a new medication regimen that controls seizures and doesn’t create bad side effects. This usually means some trial and error, especially when people take a combination of drugs. For example, your doctor may ask you to taper one medication so he or she can tell which one is causing the new side effect.
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