Anticonvulsant drugs work very well. They may have worked so well for you that you have not had a single seizure for two years or more. In that case you no longer have epilepsy, because epilepsy is defined as the occurrence of two or more seizures within a period of two years. So can you at last give up taking anticonvulsant drugs?
For someone who has had to take anticonvulsant medication every day of their life, maybe for years on end, coming off their drugs can seem like coming out of prison. It is the ultimate goal of treatment. And yet for adults, this is not an easy decision to make. There is always a small risk that when anticonvulsant drugs are stopped, seizures may recur, and if they do, control will be harder to re-establish. Secondly, there is a risk that withdrawal of the drug may itself cause a seizure, and if this happens you will be unable to drive for one year, even if you have no other seizure during this time.
If you have had no fits for two to three years, discuss the risks and benefits of giving up drugs with your doctor. What they advise will depend partly on how easily your seizures came under control in the first place. If, when your seizures first began, you immediately became seizure-free when you were put on drugs, there is a very good chance that your fits will not recur once your medication is stopped. Then it makes good sense to gradually reduce your drugs after two or three years, and perhaps eventually tail them off completely. However, if your seizures proved more difficult to control in the first place, then you are running more of a risk if you stop taking anticonvulsant medication. The seizures may start again, and if they do, there is no guarantee that they will be brought under control so successfully again. You will have to decide whether the benefits of giving up your drugs make this a risk you are prepared to run.
For children, the risk of seizures starting again after anticonvulsants have been withdrawn is rather less. In most children who have taken anticonvulsants for two years or more and been seizure-free, drugs can be withdrawn without the risk of seizures recurring. Two years after stopping treatment, three-quarters of children will still be seizure-free.
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26Mar
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