Using Epilepsy Medications After Surgery

Tapering epilepsy medication therapy after surgery did not affect seizure outcomes in the long term

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) People with epilepsy sometimes choose brain surgery to prevent seizures and stop taking medicine. Some patients wait longer than others to reduce their medication after surgery.

Recently, researchers examined epilepsy patients who had undergone surgery to see how the use of epilepsy medications after surgery affected seizure outcomes shortly after the operation and in the long term.

These researchers found that patients who tapered or withdrew from their medication regimen shortly after surgery were less likely to be seizure-free in the six months following surgery. However, in the long term, adjusting treatment did not affect seizure outcomes.

"If you have epilepsy, talk to your doctor about treatment options."

Ruta Yardi, MD, of the Department of Neurology at Cleveland Clinic, and colleagues conducted this study.

Epilepsy is a condition characterized by recurring seizures. This study specifically looked at temporal lobe epilepsy.

Epilepsy patients who do not respond well to medications sometimes choose surgery in hopes of both stopping their seizures and withdrawing from their antiepileptic medications.

Dr. Yardi's research investigated how medication management after epilepsy surgery affected short- and long-term seizure outcomes.

The researchers used 609 patients who had undergone surgery for temporal lobe epilepsy from 1996 to 2011. Each of the patients had at least six months of follow-up after the procedure.

Information was collected on each patient's medical history, medication usage and seizure frequency.

At the time of surgery, each participants had been taking an average of about two types of antiepileptic medications.

At the last follow-up, 229 patients (38 percent) had continued to take the same medications, while 380 patients (62 percent) had stopped taking their medication or reduced their doses.

By the last follow-up, 55 percent of the patients had experienced a seizure. Patients who had more seizures before the operation and a history of seizures affecting both sides of the brain were more likely to have a seizure before the last follow-up.

Among patients who reduced or stopped taking their medicine, an earlier reduction in their drug regimens was associated with having a seizure by the last follow-up.

However, the researchers found that patients who began withdrawing from antiepileptic medications were just as likely as the other patients to achieve freedom from seizures in the long term.

These researchers concluded that early withdrawal from epilepsy medication may affect rates of seizure freedom for the first six months after surgery. However, in the long term, withdrawal did not appear to affect seizure outcomes.

This research was presented at the American Epilepsy Society 67th Annual Meeting on December 7. The researchers did not disclose funding sources or conflicts of interest.

Review Date: 
December 3, 2013
Last Updated:
December 9, 2013