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Should I continue treatment for epilepsy?

Dr RK Sabharwal
Senior Consultant, Child Neurology & Epilepsy,
Sir Ganga Ram Hospital,
New Delhi

Q: I am a 39 years old male. I had a single tonic clonic seizure some eight years ago. This was noticed when I was fell down unconscious. I met a neurologist immediately who asked me to get an EEG done. After checking the report I was advised to be on medication. I was on Tegrital CR 200 mg for almost two and a half years. During this time I didn't get any seizure. In the middle of treatment, I shifted to new a location because of which I consulted a new doctor. He advised me to quit the medication after two and a half years once he found that my EEG is normal. I haven’t had any seizure in these eight years but still fear it. Because of this fear, I am sinking into depression and taking C-PRAMS S 10 for the last five years. Did I do anything wrong in discontinuing the medicine prescribed to me for seizures? Why am I sinking into depression?

A:The guidelines for stopping antiepileptic medications, has been suggested by experts after they analysed reports and studies published in medical literature. Most neurologists would not start treatment after a single convulsion, if the EEG and MRI brain are normal and there is no family history of epilepsy. The consensus is emerging that a 2-3 year treatment period (with no fits during this period) may be adequate in selected cases of epilepsy. The fact that you had a solitary fit, took 2.6 years of treatment, and have not had a recurrence of fit is a very good sign, Do not worry about the 3 year period. A number of us would agree that stopping the treatment after 2.6 years was a good idea. A number of us would have stopped the treatment after a 2 year fit-free period in your case. At present, our concern is regarding your depression and anxiety. First and foremost, remember that you have successfully been treated for fits and the medicine was withdrawn at the right time. Start exercising, develop a hobby, mix with friends, and understand that by worrying you are not going to change things. Meet your psychiatrist periodically and learn ways and methods, besides medicines of course, by which you can improve your coping skills and improve on your strengths. Good Luck.