I’m Seizure Free!… Can I stop my meds now?

One of the most common questions asked by patients with a history of epilepsy is when they can stop their medications. This can be a complex question because some patients may require medication for their lifetimes while others may be able to safely stop their medication. Similar to other decisions in regard to epilepsy, this decision needs to be individualized and will vary depending on the cause and type of epilepsy.

Stopping anti-seizure medications can come with some benefits, such as eliminating the drugs’ side effects, decreasing the drugs’ interactions with other medications, improving quality of life, and saving on medication costs.

However, these benefits must be weighed against the risk of seizure recurrence. Factors such as the patient’s occupation, driving status and risk of injury with seizures also should be taken into account.

In general, it is recommended that a patient reach at least 2 years of complete seizure freedom. Stopping anti-epileptic medication does come with a risk of seizure recurrence, which is most likely within the first 2 years, especially the first 6 months.

People with previously hard-to-control seizures, those who require multiple medications, and people who have abnormal neurological exams are at higher risk of recurrent seizures.

Often electroencephalogram (EEG) studies will be done prior to or during the medication tapering process. Abnormalities during these studies indicate a higher likelihood of seizure recurrence.

Children with easy-to-control seizures and patients who had isolated seizures in the setting of certain conditions- such as fever, drug use, or recent brain injury/surgery are often successful at remaining seizure-free while off medication.

Seizure medication should never be stopped abruptly or without consulting a healthcare provider, ideally a neurologist.

If you have questions about whether you may be a candidate for stopping anti-seizure medications, consider consulting with an epilepsy specialist.