Medication Therapy

Medication

Initial treatment is usually in the form of anti-epileptic medications. Carbamazepine (Tegretol®) being the first drug of choice. When medication fails, surgery may be considered.

Type Drug Brand Name Manufacturer
Anti-epileptic Carbamazepine Carbatrol, Equetro, Tegretol, Tegretol XR Shire Pharmaceuticals, Validus Pharmaceuticals, Novartis Pharmaceuticals
Anti-epileptic Felbamate Felbatol Meda Pharmaceuticals
Anti-epileptic Gabapentin Neurontin Pfizer
Anti-epileptic Lamotrigine Lamictal GlaxoSmithKline
Anti-epileptic Levetiracetam Keppra UCB
Anti-epileptic Oxcarbazepine Trileptal Novartis Pharmaceuticals
Anti-epileptic Pregabalin Lyrica Pfizer
Anti-epileptic Tiagabine Gabitril Cephalon
Anti-epileptic Topiramate Topamax Ortho-McNeil-Janssen Pharmaceuticals
Anti-epileptic Valproate Depakote, Depakote ER, Depakene, Depacon, Valproate, Valrelease Abbott Laboratories
Anti-epileptic Zonisamide Zonegran Dainippon
Anti-spasticity Baclofen Lioresal, Lioresal Intrathecal, Gablofen Various Drug Companies
Anti-epileptic Phenytoin Dilantin, Phenytek
Anti-epileptic Clonazepam Klonopin, Rivatril
Anti-depressant Amitriptyline Elavil
Anti-depressant Protriptyline Vivactil
Anti-depressant Nortriptyline Pamelor
Anti-depressant Fluoxetine Prozac, Seronil, Fontex
Anti-depressant Trazodone Desyrel
Opioids Morphine
Opioids Codeine
Opioids Fentanyl
Opioids Hydrocodone
Opioids Hydromorphone
Dermatologic Lidocaine
Dermatologic Lidoderm patch
Dermatologic Lidocaine cream
Dermatologic Capsaicin
Antianxiety SSRIs Paxil, Celexa
Antianxiety Benzodiazepines Ativan, Valium, Xanax, Klonopin
Analgesic Ultram Tramadol
Analgesic Ketamine
SNRIS Venlafaxine Effexor – serotonin/norepinephrine reuptake inhibitors
SNRIS Duloxetine Cymbalta – serotonin and noradrenaline reuptake inhibitor

Why medications may not work (Jeffrey Cohen, MD, PhD, Beth Israel Medical Center, New York).

  • Diagnosis may be incorrect
  • Not well tolerated
  • Not used incorrectly
  • Started too quickly
  • Dose not high enough
  • Expectations not well explained
  • Possible side effects need to worked with
  • Combinations may be needed