How do these drugs even work?

[jamesw]

I'm new to this community and this diagnosis, so please forgive my ignorance.

But how do the anti-epileptic drugs work exactly? Maybe I should tell you where my question is coming from: I had my first grand mal 9 years ago and the second in May. I recently realized that I had been having simple partials in the intervening years, and those episodes have continued after three months on 2000mg of Keppra. What I'm wondering is, if the Keppra isnt keeping the smaller seizures at bay, does that not bode well for the control of any future grand mals?

I've just been really paranoid and anxious ever since this most recent grand mal, not knowing if they're going to be more frequent, not having any warning signs before a seizure, and now this fear that this awful drug I've been taking might not even be working.

For the record, I haven't had an EEG or anything since I was hospitalized in May.

 

[MonkeyBoy]

I wrote this to another new member today:

"My thought would be "why" go straight to prescription medicines until you have ruled out the possible influencers that may be contributing to or even causing your seizures as well as made dietary lifestyle changes with a Ketogenic (Low Carb - High Good Fat) Style Diet to include adding critical supplements like B6 and Magnesium Malate to name a couple? Have you thought about MCT Oils as well? Are you getting enough sleep? How much MSG and Aspartame do you consume now? You may end up on meds in the end but why start there first? Go slow and do the research and the practical work first. Read RobinN's great posts front to back as a start. While it may be scary and confusing at this time slow things down and take charge. It will certainly require a different set of rules until you get it all worked out as well as time but consider the alternatives. Best wishes as you begin your journey....."

So my question to you is "why" take the normal response to your own situation by medical doctors without first researching and trying to do it by other means? Just a thought? I wish you the absolute best and hope you are able to gain control over the situation. Test any and all advice you get before you accept it understand it!!! Doctors work for us so use them in that manner but be in charge and in control.

 

[jamesw]

I suppose I'll admit I hadn't considered other treatment options or even to question my neurologist. I'm still trying to figure out how to be my own advocate where my health is concerned. Thank you for the nudge

 

[Dolores]

This is indeed a most interesting question.
What is happening in my brain and how does Dilantin prevent seizures from occurring?

Here's the explanation I have discovered. It fits what I have been told about what is happening. And now I understand why my brain "needs" Dilantin, what Dilantin actually does.

My brain
(The Brain from Top to Bottom)
... Nerve conduction is an electrochemical process, which means that it uses electricity made with chemical molecules. ... the brain’s electricity is caused by the movements of electrically charged molecules through the neurons’ membranes.
The underlying basis of nerve conduction consists essentially of electrical and chemical forces that cause ions to move.

The membrane of a neuron, like that of any other cell, contains tiny holes known as channels. It is through these channels that charged molecules pass through the neural membrane.

But unlike the channels in other cells, the channels in neurons are so specialized that they can coordinate the movements of these charges across the membrane so as to conduct nerve impulses.

Sodium Channels
... Genetic diseases that alter sodium channel inactivation can cause muscle stiffness or epileptic seizures because of the introduction of a so-called window current, during which sodium channels are tonically active, causing muscle and/or nerve cells to become over-excited

My brain on drugs (How Dilantin Works)
... Dilantin blocks these sodium channels and increases the time the nerve cell needs to recover. This suppresses seizure-causing electrical activity in the central nervous system. ... Dilantin also decreases the ability of calcium ions to inter into cells.

I do like knowing what is happening and why. I'm not just taking a drug "hoping it will work". In my case the drug does what it's supposed to, keeps the ions flowing and the channels opening and closing thereby preventing seizures.

I could possibly achieve the same effect some other way. But I never want to have another grand mal seizure. So I choose not to play around with alternatives. Especially since I can manage the side effects.

I don't know about keppra but I have read that many anticonvulsants work in a similar manner.

Hope that helps.

 

[jamesw]

Thank you for all the info! I'm also someone who likes knowing "what's happening and why." Which has made approaching my seizures very frustrating because all I've been given by doctors is "we don't know." ugh.

 

[julie wishes]

Well when I questioned my doctor I got an "I do know a thing or two!!!!! I've been doing this twenty years!!!!! ". She actually said that in an aggressive tone. I feel these are very valid questions that doctors should be answering. So keep searching.

 

[epileric]

Here's a good site that tells you in a nutshell how AEDs work as well as how they're classified & what other uses they have. Just as a footnote, phenytoin mentioned on the site is the chemical name for Dilantin that Dolores mentioned.

How do Anticonvulsants work?

Anticonvulsants are capable of depressing abnormal neuronal discharges in the CNS that may result in seizures. They may work by preventing the spread of seizure activity, depressing the motor cortex, raising seizure threshold, or altering levels of neurotransmitters, depending on the type.

Anti-seizure medications are used singly or in combinations depending on the type and degree of seizure activity.

http://www.healthystock.net/category/anticonvulsants.shtml

 

[Eli]

I recently realized that I had been having simple partials in the intervening years, and those episodes have continued after three months on 2000mg of Keppra. What I'm wondering is, if the Keppra isnt keeping the smaller seizures at bay, does that not bode well for the control of any future grand mals?

Welcome to cwe! You will find a wealth of knowledge and a great support group here.

Over the years that I've dealt with my epilepsy I to, like you and probably most of us have asked the same question regarding our meds. After trying several different meds, going off of meds, making numerous dietary and lifestyle changes and then being put on keppra I have found a good balance.

I have alotttttt of partial seizures, they are easily triggered and many days are just pure hell for me. But the keppra does mostly control the grand mals (t/c's) for me as long as I stay away from too many triggers. So for me Keppra is a blessing, given that pre-keppra it wasn't unusual for me to have a mix of several dozen partials and t/c's a week. My epileptologist said the keppra was being used to help control my t/c's but a secondary med would be needed to help with my partials. We couldn't find one I could tolerate so I just live with them.

For me, tracking/journaling my sleep, diet, hormones, daily activities, sz activity, etc helped give me insight into my epilepsy and I am more comfortable living with it.

Hope that helps.

 

[Cint]

I wrote this to another new member today:

"My thought would be "why" go straight to prescription medicines until you have ruled out the possible influencers that may be contributing to or even causing your seizures as well as made dietary lifestyle changes with a Ketogenic (Low Carb - High Good Fat) Style Diet to include adding critical supplements like B6 and Magnesium Malate to name a couple? Have you thought about MCT Oils as well? Are you getting enough sleep? How much MSG and Aspartame do you consume now? You may end up on meds in the end but why start there first? Go slow and do the research and the practical work first. Read RobinN's great posts front to back as a start. While it may be scary and confusing at this time slow things down and take charge. It will certainly require a different set of rules until you get it all worked out as well as time but consider the alternatives. Best wishes as you begin your journey....."

So my question to you is "why" take the normal response to your own situation by medical doctors without first researching and trying to do it by other means? Just a thought?

It also does take time when starting meds to find the right one and getting the right dosage, even getting the correct diagnosis of the type of E one is suffering. That is what doctors are supposed to do, help you find what is going on inside your head so you can know which treatment to take. I don't think you can do this totally on your own without the correct testing and by reading things on the internet. Just my thought(s).

And my question to you is, have you researched ALL side effects of the Ketogenic diet? There are side effects for some to that treatment, check this link:
SIDE EFFECTS ON THE KETOGENIC DIET: IDENTIFICATION AND TREATMENT
http://www.epilepsy.com/epilepsy/keto_news_november07

You can also find another link about the Ketogenic diet for adults at John Hopkins, all good.
DIETS AND ADULTS: AN UPDATE FOR 2011
http://www.epilepsy.com/epilepsy/keto_news_mar11

I have never tried this diet because my E started years ago and I already had surgery before this diet became so popular and I have diabetes, so I do watch my diet very carefully.

 

[MonkeyBoy]

I learned long ago the following that is so true:

"A convinced mind is an unchanged mind."

 

[Dolores]

I learned long ago that everyone is different.
To force my beliefs on someone else without first understanding all the details of their situation is arrogant.
What I know works for me in my situation. I share it not with the intent of changing others but rather the hope that maybe some of what I've been through and discovered that works for me (and why) will also help someone else.

I do not belittle anyone regarding their choice in how to deal with their situation.
While some may belittle me in my choice, I remain confident in myself becaus my choices allow me to live a wonderful life

 

[Cint]

And I learned long ago to trust my own instincts, not follow what someone else says will work.