Medicines to Treat Seizures

Definition

The term "convulsion" defines a group of abrupt, violent, uncontrolled and sudden contractions of the voluntary musculature. During seizures, the muscles contract and relax continuously for a variable period of time. The longer the seizures last, the greater the severity of the clinical picture. In the absence of neurological damage, seizures do not cause any permanent damage, although they can induce a temporary loss of consciousness.

Causes

Seizures are not an actual disease; rather, they are a symptom of numerous pathologies. The most recurrent diseases associated with seizures are: alcoholism, poisoning, brain damage (due for example to encephalopathy or trauma), metabolic disorders, drugs, epilepsy, neuroleptic drugs, fever, viral and bacterial infections, malignant hypertension, electric shock, tumor cerebral. Convulsions also occur in eclampsia.

Risk factors: rapid rise / fall in fever, genetic predisposition, viral infections, fever, premature birth

Symptoms

The vast majority of seizures are characterized by some common symptoms: involuntary and uncontrolled agitation of the skeletal muscles, cyanosis, difficulty in breathing, lack of control of the anal and bladder sphincter, uncontrolled eye movements, loss of consciousness, foam in the mouth, fainting.

Complications: In severe cases, seizures can cause permanent neurological damage or lead to epilepsy

The information on Seizures - Drugs for the Treatment of Seizures is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Seizures - Medicines to Treat Seizures.

Medicines

Pharmacological treatments aimed at stopping or preventing seizures are the subject of heated debate, since different opinions coexist on this matter. From the careful analysis of scientific sources, it is possible to draw some interesting considerations. Until a decade ago, it was believed that the intake of anticonvulsant drugs (benzodiazepines) as a preventive measure was important to avoid both the transformation of the seizure into epilepsy and a possible recurrence of the seizures. Today, this therapeutic approach is discarded: it seems that the possible risks deriving from such a therapy far outweigh the benefits.
Contrary to what has been believed in the past, some seizures do not need treatment. A classic example is febrile seizures, typical of children aged between 6 months and 6 years: in the absence of neurological damage, simple febrile seizures should not be treated with any drug, except for therapeutic aids (antipyretic drugs). Some authors consider it appropriate to administer anxiolytics and muscle relaxants (such as diazepam, eg Valium) to the child DURING the convulsion lasting more than three minutes. However, not all scholars approve this theory: treatment with benzodiazepines is a much debated topic, and does not always find any real indication. Clearly, it is imperative to isolate the factor that triggered the fever, and the patient should be treated accordingly. When the fever is caused by a "viral infection, the young patient must take antiviral drugs; if the fever is triggered by bacterial insults, the therapy of choice is antibiotic. The most suitable drug therefore depends on the cause that induced the convulsion. In some circumstances, however, the "therapeutic approach" must be based in a different way:

Convulsion occurs in young children, aged less than 6-12 months
The duration of the convulsion exceeds 15 minutes
The patient with the seizure has pre-existing neurological damage
Genetic predisposition to seizures / epilepsy
Febrile seizure occurs with a relatively low fever (

Let's see more precisely what are the most used drugs to calm convulsions.

The following are the classes of drugs most used in the therapy against seizures, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:

Anticonvulsant drugs

Sodium valproate (eg Depakin, Ac Valproico); for the treatment of seizures in adults, the drug should be taken at a dose of 10-15 mg / kg per day, dividing the load into 4 doses. Do not exceed 250 mg per day. The side effects of the drug are dose related. For the child suffering from seizures, the dose should be reduced. The drug is sometimes used for the prevention of seizures in adults and children. Consult your doctor.
Diazepam (eg. Micropam, Ansiolin, Diazepam FN, Valium, Diazepam, Valpinax): for the treatment of seizures in the ADULT take a dose of the drug orally ranging from 2 to 10 mg, twice a day. Rectally, administer 0.2 mg / kg of drug (round to units). If necessary, repeat the dose every 4-12 hours. Such therapy makes sense when seizures occur to the utmost 1 time every 5 days, for no more than 5 episodes per month. FOR THE CHILD aged between 2 and 5 years suffering from seizures (febrile or otherwise), it is recommended to administer 0.5 mg / kg of the drug, rounded up to the unit. For affected children between the ages of 6 and 11 years, the recommended dose is 0.3 mg / kg Over 12 years, administer 0.2 mg / kg of the drug If necessary, repeat the administration every 4-12 hours.

DO NOT give the drug to children under 6 months of age: such behavior could lead to CNS depression. Children between the ages of 6 months and 2 years could take the drug, but the dose should be carefully determined by the doctor.

Phenytoin (eg Metinal Idantoina L, Dintoinale, Fenito FN): the drug is also used in therapy for the prevention of tonic-clonic seizures. Generally, the dosage for ADULTS involves taking the drug intravenously at a dose of 10-15 mg / kg by slow injection into a vein (no more than 50 mg per minute). The maintenance dose for adults with seizures suggests taking 100 mg of the IV drug. every 6-8 hours. It is not recommended to take the drug intramuscularly: in this case, the absorption of the drug is irregular and unpredictable. It is also possible to take the drug orally: 1 gram (total), divided into a first dose of 400 mg followed by from another two doses of 300 mg. Between one dose and the next, it is advisable to allow 2 hours to pass. For CHILDREN suffering from seizures, administer 15-20 mg / kg of the drug orally. The loading dose can be taken in three doses given at 2-4 hour intervals. For the maintenance dose: consult your doctor.
Levetiracetam (eg. Keppra, Levetiracetam Sun): the drug is not indicated for the treatment of febrile seizures in young children. For children over 12 years of age suffering from myoclonic seizures, it is recommended to take a dose of medicine equal to 500 mg, twice a day. If necessary, increase the dose by 500 mg every 2 weeks, up to a maximum of 1,500 mg, twice daily. The efficacy of the drug taken at doses greater than 3 grams per day is not established. The treatment of tonic-clonic seizures in children aged 6 to 16 years, plan to take 10 mg / kg of immediate-release drug, twice a day. If necessary, increase the dose by 10mg / kg every 2 weeks, up to a maximum of 30mg / kg. For partial seizures the dose depends on age: it can vary from a minimum of 7mg / kg per dose (2 times a day) for children aged 1 month to 6 months, up to a maximum of 10 mg / kg per dose (2 times a day) for children aged between 4 and 16. Eventually, these dosages can be increased no earlier than two weeks after the start of treatment. Always consult your doctor before taking the drug or modulating therapy.
Lacosamide (eg Vimpat): convulsions can be treated with an oral or intravenous administration of lacosamide. Initiate therapy with a dose of 50 mg of medicine, to be taken twice a day. If necessary, in case of recurrent convulsions, the dosage can be increased up to 100mg / day, at weekly intervals, up to the maintenance dose of 200-400mg / day. Take the drug with or without food.
Pyridoxine or pyridoxine (eg Benadon): for children suffering from seizures related to pyridoxine dependent syndrome, it is recommended to take 10-100 mg of drug intramuscularly or intravenously, followed by 2-100 mg of drug to be taken intravenously oral.
Zonisamide (eg Zonegran): this anticonvulsant drug is often used in combination with other drugs, especially in the treatment of partial seizures. Initial therapy usually involves taking 100 mg of medicine once a day for at least two weeks. If necessary, increase the dosage to 200 mg daily for another 2 weeks. If necessary, the dosage can be further increased. The drug is not indicated for the treatment of a child's febrile seizures.
Acetazolamide (eg Diamox): drug of choice in the treatment of the oedematous condition caused by heart failure. The drug is also particularly useful for the improvement of pulmonary edema and dyspnoea in the context of left heart failure. However, recent studies have shown the effectiveness of this drug also for the prevention seizures, especially in young patients with mild epileptic seizures. Generally, this benzodiazepine is used in therapy as a complementary treatment to that with classic entiepilectics. In this sense, it is possible to administer 8-30 mg / kg of drug per day, possibly divided into 1-4 daily doses. Do not exceed one gram per day. If the patient is already taking other anticonvulsant drugs, reduce the dose of acetazolamide to 250 mg per day. Most of the time, patients taking the drug on its own respond well to a dose of 375-1000 mg per day. Do not administer for the treatment of the child's febrile seizures.
In this sense, the recommended dosage for the prevention of seizures in the context of eclampsia provides for the assumption of 4-5 g of a 5% solution every 4 hours. Alternatively, administer the drug intravenously at a dose of 4 g of a 10-20% solution (not to exceed 1.5 mL / min of a 10% solution). The maintenance dose suggests taking 1-2 grams of the drug every 60 minutes. Do not exceed 30-40 grams per day.

Medicines for the treatment of convulsions from bacterial / viral infections

Benzylpenicillin (eg. Benzyl B, Penicillin G): indicated to treat seizures dependent on meningococcal and pneumococcal infections. In the first case, intravenous infusion of 6,000,000 IU every 4 hours (or 24,000,000 units per day) is recommended for 14 days or until the fever subsides. For the treatment of pneumococcal meningitis, administration of penicillin is recommended. G, 4,000,000 IU aqueous solution, every 4 hours for 2 weeks.
Rifampicin (eg Rifampic): is a bactericidal antibiotic to be taken orally (600 mg tablets) or intravenously, once a day for 10-14 days. It is indicated in the treatment of convulsions in the context of pneumococcal, meningococcal or from meningitis Haemophilus influenzae.
Aciclovir (eg. Aciclovir, Xerese): indicated in case of convulsions in the context of a suspected Herpes Virus infection. The dosage must be established by a physician.

Medicines for the treatment of febrile seizures

Paracetamol is the first-line drug for lowering fever in the context of febrile seizures in the newborn and infant. As analyzed, the rapid increase or decrease in fever - even if not excessively high - can be a trigger for seizures in healthy children.

Paracetamol or acetaminophen (eg. Tachipirina, Efferalgan, Sanipirina, Piros, Tachidol): the administration of this medicine is useful for lowering the fever, an omnipresent symptom in the child's febrile seizures. The recommended dosage depends on the age and weight of the child, therefore it must be established by the doctor.

Paracetamol is the drug of choice used to lower fever in the context of febrile seizures.