Epilepsy Talk

Anti-Epilepsy Drugs Lose Effectiveness Over Time… | March 2, 2017

It may be the dose prescribed…the type of epilepsy you have…even something as simple as your age or weight. But research shows that, over time, the effectiveness of your anti-epilepsy drug may decline.

Almost all first, second and third-generation epilepsy drugs lose their efficacy after prolonged treatment.

Perhaps it’s because your metabolism builds up a tolerance to the drug. And ramping up the dosage can work.

Or it may be a functional tolerance where your brain receptors have become resistant to the drug. In that case, a change in medications may help. But whatever the cause, you’re not alone…

Patients showing tolerance to traditional drugs

A critical review by Dr. Wolfgang Loscher and Dr. Dieter Schmidt shows that repeated administration of anti-epileptic drug (AED) therapy has diminishing results in preventing seizures in epileptic patients.

In clinical trials, the number of patients remaining seizure-free declines over time with prolonged treatment.

This review explores how acquired tolerance, the adaptive response of the body to foreign substances, as opposed to innate tolerance (which occurs in patients naturally resistant to certain medications) is responsible for this diminishing effect.

The risk of developing a tolerance to AEDs was traditionally thought to be small.

Loscher and Schmidt, however, conclude that while AED tolerance is not a serious issue for most sufferers of epilepsy, it is a significant aspect of treatment in some patients.

A few may even develop a cross-tolerance to similar medication. This “multi-drug resistance” is of serious concern to patients with medically intractable epilepsy.

The findings directly conflict with the treatment method many doctors are currently using…

It is standard practice to increase AED dosage until adequate seizure control is obtained. However, this protocol presents a number of issues.

The threat of medication tolerance is generally overlooked, as is the idea that epilepsy can be a progressive disease and does not develop at a fixed rate.

Further, patients may acquire a tolerance to some effects of a particular drug, but not all.

Loscher and Schmidt have spent decades studying the effects of AEDs, however, Loscher believes that AED tolerance is a topic that has yet to be fully explored, and that more long-term clinical trials are becoming increasingly necessary.

“Despite the convincing experimental evidence,” says Loscher, “tolerance to the effectiveness of AEDs seems to have been forgotten.”

Research is currently being done on the effects of placebo and conditional tolerance (a mental, conditioned-response effect that the mind has over the body).

Doctors are also studying the effects of lower initial and target doses of AEDs.

The possibility exists that many patients are being over-medicated from the start, posing a significant challenge to doctors and scientists working toward effective seizure control.

This study was published in Epilepsia magazine.  Epilepsia is published on behalf of The International League Against Epilepsy (http://www.ilae-epilepsy.org/) the world’s preeminent association of physicians and other health professionals working towards a world where no person’s life is limited by Epilepsy. Its mission is to provide the highest quality of care and well-being for those afflicted with the condition and other related seizure disorders.

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Resources:

http://www.sciencedaily.com/releases/2006/09/060911111533.htm

http://www.ilae.org/visitors/documents/guidelines-epilepsia-12074-2013.pdf

 


15 Comments »

  1. The neurologist that I have now and for the past 2 years, said to me 18 months ago the following. When drugs never seems to work for stopping seizures over a long period of time, “” like all my life for 50 + years””,, then the drugs do nothing for the person with seizures, while the condition over the years, gets worse in time, as the drugs only suppress & limits brain growth from the child stage of that brain, to develop normally & in the normal pace the brain needs to develop. And I was thinking after hearing all of that, THE THOUGHTS & words I tried to tell my doctors & my parents in the 1960’s & 70’s when I said to them all,, THE DRUGS ARE NOT HELPING ME,,, & IF THEY WERE,, I WOULD NOT HAD BEEN HAVING MORE SEIZURES AS I GOT OLDER, from child, to teenager years & 20’s, 30’s & older. So,,, CAN I SUE DRUG COMPANIES NOW & a few doctors who ONE is dead I know. Nobody is accountable for their brain destroying drugs when they are given to kids. Besides,, they ALL KNOW as kids like we were, and what kids are today to these people, as with me,, they believe KILL THE BRAIN SILENTLY WITH DRUGS FIRST AT A YOUNG AGE,,, then when older decrease the MGS of the drugs, only to make the people with seizures after 18 years old, like they are ”’going to have a life”” then after 25 to 35 years old the human brain will destroy itself when NOTHING where drugs are a concern will help the brain. That’s what happened to me after 56 + years with seizures. Besides myself & my MOTHER,, Who else is my ADVOCATE ? Not AMA, EFA, CURE, FDA, CDC, NIH, AAN, or neurologists. YES,, I had brain surgery 16 years ago, after 41 years of FAILED drugs. I need more drugs,, right ? Maybe I can afford to retire at age 98. Really ? Talk about that sometime too. A FUTURE,,,, WE HAVE THAT ?

    Like

    Comment by C D — March 2, 2017 @ 9:53 PM

  2. I have been on Depakote and Keppra for a very long time now. My body has become immune to them. I have been on high doses and for so long it will be difficult to get off the meds.

    Like

    Comment by Nicole Koloski — March 2, 2017 @ 10:11 PM

    • But, if they’re not working, you should get off them…slowly…and get diagnostic testing to see which drug might be best for you.

      One suggestion is Continuous Video EEG Monitoring – which (if you forgot) studies the brain waves over time.

      Continuous monitoring can characterize the seizure type for more precise medication adjustments and locate the originating area of seizures within the brain.

      Like

      Comment by Phylis Feiner Johnson — March 2, 2017 @ 11:01 PM

  3. Is there hope with people with epilepsy taking cannibus oil instead of drugs_ My doctor says it is just for kids and ignored me as he only believes in drugs and I am constantly looking for alternatives.

    Like

    Comment by Mary Jane Levell — March 3, 2017 @ 10:04 AM

  4. since they put me back on the right track with my med,s. My last eeg showed That I didn,t seizure I guess I out grew them. Now my life will be more better than it was, I hope.

    Like

    Comment by Michele Metzger — March 3, 2017 @ 10:50 AM

  5. Mary Jane, you also might consider one of the anti-epilepsy diets. (I find the Modified Atkins Diet the most “user-friendly”.)

    Three Anti-Seizure Diets That Could Change Your Life…

    https://epilepsytalk.com/2009/10/04/eating-well-is-the-best-revenge/

    Good luck…

    Like

    Comment by Phylis Feiner Johnson — March 3, 2017 @ 10:53 AM

  6. Have you heard of Aptiom ?
    My old drugs are looking the potency so doc wants to put me on that.

    Like

    Comment by Bonnie — March 5, 2017 @ 3:21 PM

  7. Thank you! My present Epileptologist has me on 4 medications because of my bodies tolerance to drugs. I read of others reactions people have and sad for them. I only hallucinated on one medication. The other medications. I look like a normal person walking down the street and partial complex seizures. I do not work at this time because of my seizures. There is a combination, I know. I take the latest combination Briviact, Aptiom, Zonegram,Depakote XR. I changed my diet , the diet keeps me more alert and definitely lowers your seizures. I had one simple partial seizure which is fantastic! I only have daily headaches, balance, nausea and vision and I apply that to medication. Exercise daily really has helped too!

    Like

    Comment by red2robi — May 21, 2017 @ 11:53 AM

    • Good for you Red, for being so proactive. I’m afraid so many others are on that endless hamster wheel…of meds, meds and more meds, that don’t necessarily work for them anymore.

      There are other options, as you say. Diet and exercise are excellent antidotes.

      Like

      Comment by Phylis Feiner Johnson — May 21, 2017 @ 11:58 AM


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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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