What is Drug Resistant Epilepsy?
If you’ve tried 2 or more seizure medications, but are unable to become, and remain, seizure-free, you may hear the phrase drug resistant epilepsy. Here’s a look at what that means.
Thinking about having a “drug resistant” condition may feel scary… what does that even mean?
The technical definition of drug resistant epilepsy as defined by the International League Against Epilepsy (ILAE) says:
Drug resistant epilepsy may be defined as failure of adequate trials of two tolerated and appropriately chosen and used AED (Antiepileptic Drug) schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom.1
In other words, if you’ve tried 2 or more seizure medications, but are unable to become, and remain, seizure-free you may be considered to have drug resistant epilepsy.
Two medical studies (Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic-clonic seizures and Early identification of refractory epilepsy – see more in references below) note that, if one medication fails to alleviate seizures in an epilepsy patient, then adding a second medication will only make them seizure-free about 11% of the time.2,3 Also, it’s possible that certain medications could create intolerable side effects or an idiosyncratic reaction which could cause medication to be discontinued.
If medication isn’t effectively treating your epilepsy, it’s important to talk to your doctor about alternate treatment options, or seek a second opinion at a specialized Epilepsy Center.
References
- Kwan, P. et al. (2010). Definition of drug resistant epilepsy: Consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia. 51:1069-1077.
- Mattson, R. et al. (1985, Jul 18). Comparison of carbamazepine, phenobarbital, phenytoin, and primidone in partial and secondarily generalized tonic-clonic seizures. N Engl J Med. 313(3):145-51.
- Kwan, P. and Brodie, M. (2000, Feb 3). Early identification of refractory epilepsy. N Engl J Med. 342(5):314-9.
Content reviewed for accuracy by Dr. Jiyeoun Yoo, MD, FAES, FACNS
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