Meds to the Rescue: Understanding Epilepsy Treatments
- Jamie Thomsen
- Apr 16
- 2 min read
People with epilepsy often rely on anti-seizure medications (ASMs) to manage their condition. Formerly known as anti-epileptic drugs (AEDs), ASMs primarily fall into two categories: maintenance medications and rescue medications. Understanding the difference between these types of medications is crucial for effective seizure management.
Maintenance Medications
Maintenance medications are taken daily to help control and prevent seizures over the long term. Many individuals with epilepsy use a combination of ASMs to achieve optimal control. These medications work by stabilizing the brain's electrical activity, reducing the likelihood of seizures.
Rescue Medications
In addition to maintenance medications, some people require "as-needed" or rescue medications to manage breakthrough or cluster seizures. According to the Epilepsy Foundation, rescue treatments are used in specific situations to stop an ongoing seizure or prevent a cluster of seizures from escalating into an emergency, such as status epilepticus.
Key Differences Between Maintenance and Rescue Medications
Purpose: Maintenance medications are taken daily to prevent seizures, while rescue medications are used during or immediately after a seizure.
Speed and Duration: Rescue medications act quickly but have shorter-lasting effects compared to maintenance medications.
Goal: Rescue medications aim to prevent emergencies and stabilize the patient in acute situations.
How Are Rescue Medications Administered?
During a seizure, swallowing pills can be challenging or impossible, so rescue medications are available in forms designed for quick and easy administration. Here are some common methods:
Intravenous (IV): In hospital settings, medications can be delivered directly into a vein for rapid effect. However, this method is typically not feasible in at-home emergencies.
Rectal Delivery: Diazepam (Valium) is available as Diastat, a gel formulation administered rectally. This option is often used for young children or in situations where other methods are not practical.
Intranasal Spray: Medications like diazepam (Valtoco) and midazolam (Nayzilam) are available as nasal sprays. These are quick to administer and less invasive, making them a preferred choice in many scenarios.
Orally Disintegrating Tablets (ODT): Clonazepam (Klonopin) is available as an orally disintegrating tablet that dissolves rapidly on the tongue, making it easier to use during or after a seizure.
Common Rescue Medications
Rescue medications are often benzodiazepines due to their fast-acting properties. Here are three widely used options:
Diazepam (Valium):
Formulations: Diastat (rectal gel) and Valtoco (intranasal spray).
Use: Rapid action to stop seizures.
Clonazepam (Klonopin):
Formulation: Orally disintegrating tablets (ODT).
Use: Quick dissolution in saliva makes it convenient in emergency situations.
Midazolam (Versed):
Formulation: Nayzilam (intranasal spray).
Use: Easy and non-invasive administration.
Choosing the Right Rescue Medication
Physicians determine the most appropriate rescue medication based on several factors, including the patient’s age, lifestyle, and seizure type. For example, intranasal sprays or orally disintegrating tablets may be more suitable for teenagers or adults in school or public settings, as these methods are less invasive compared to rectal administration.
Final Thoughts
Rescue medications are vital tools in managing epilepsy, providing rapid relief and preventing emergencies. With advances in formulations and delivery methods, patients and caregivers have more options than ever to ensure effective and dignified treatment. Always consult a physician to determine the best approach for individual needs.
Resources:
Epilepsy Foundation: https://www.epilepsy.com/treatment/seizure-rescue-therapies
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