Antiepileptic drug therapy for people with developmental disability

Antiepileptic drugs are the mainstay of treatment for people with epilepsy, including those with an associated developmental disability.

The principles of use of antiepileptic drugs are discussed in the Neurology guidelines.

People with developmental disability and fully controlled epilepsy should be reviewed by their general practitioner (GP) at least every 6 months and by their specialist every 12 months.

Although drug therapy is generally recommended after the second seizure, consider therapy after the first seizure when the risk of recurrence is high. This will include most people with developmental disability. See Deciding when to treat epilepsy. The impact of seizures on the person’s quality of life (see considerations for managing epilepsy and seizures) should be taken into account.

For advice on drug choice, see Choosing an antiepileptic drug.

For management of habitually prolonged or repetitive seizures, see here.

Some epilepsy syndromes associated with developmental disability (eg Lennox–Gastaut syndrome) are more likely to respond to some antiepileptic drugs than others.

In people with Dravet syndrome, Lennox–Gastaut syndrome or tuberous sclerosis, cannabidiol (a non-psychoactive cannabinoid) has shown modest efficacy against seizures in clinical trials.