Hi,
Welcome to icliniq.com. I went through your query. I can understand your concern about long-term effects of antiepileptic medications. So, in reply to your query, I would like to make suggestions for your son as follows:
Treatment of many types of childhood epilepsy requires long-term antiepileptic medications, sometimes for years together. Hence, your doctor (a neurologist) always has to judge the minimum dose that is adequate to prevent seizures and also to take care that the dose does not cause side effects.
Dose of most of the drugs in children is decided by weight and not by age. At present, I assume that your son's weight is around 14-15 kg.
1. Lobazam (Clobazam) helps to control many types of seizures. The most common side effect is sedation; hence it is best given before going to bed. Other possible side effect is drowsiness in morning or during the day.
2. Above are the most common side effects. Rarely, some children may become paradoxical aggressive or excited. In such cases you should reconsult your doctor.
3. Regarding Topamac (Topiramate), I would like to mention two points specifically. First please monitor the weight of your son monthly, as it can cause both weight gain and weight loss.
And the second is please make sure that your son is taking plenty of liquids during the day to avoid a remote risk of developing renal stone. Renal stone is not common, but a possible side effect with Topiramate.
1. Allergic reactions can occur as a side effect of any of the medication. So, if you see any new rash developing in the body, please inform your doctor.
2. Please do not discontinue antiepileptic medications without asking your doctor. After three months, as suggested by your doctor, please give a follow up to your doctor. So, he will assess your son and will decide about the need of continuation.
3. I would like to mention here that the doses that your son is receiving at present are not very high. So, that is a positive. However, if you see any new symptom or possible side effect, please report to your doctor.
4. Please take all possible measures to avoid factors that may precipitate seizures. Such as avoidance of physical or mental strain, avoidance of excessive hunger, control of fever with proper medications and tepid sponging, etc.
5. Please make sure that all the antiepileptic medications have side effects. So, it is usually the best option to choose proper medications that control seizures as well as do not cause side effects.
At present, I would agree with your neurologist's opinion. However, a neurologist is usually the best expert to manage childhood epilepsy.