What alternate medication can I take for my seizures at 24?

Question

Hello doctor,

I am a 24-year-old man who has had two generalized seizures in the past six months. EEG (electroencephalogram) showed left temporal spikes, and MRI (magnetic resonance imaging) brain revealed a small left hippocampal sclerosis. I have just started on Levetiracetam, but feel irritable and foggy. Please tell me,

Are there alternative medications with fewer mood-related side effects?
Can I ever drive again?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your EEG (electroencephalogram) and MRI (magnetic resonance imaging) findings indicate focal epilepsy originating from the left temporal lobe due to hippocampal sclerosis. Levetiracetam (an antiepileptic medication) is a common first-line drug for focal seizures because it is generally effective and well-tolerated.

But in some people, it can cause side effects like,

Irritability.
Mood swings.
Brain fog.

If these symptoms persist, your neurologist may consider alternatives such as Lamotrigine (a phenyltriazine antiepileptic, which often has a more favorable mood profile), Lacosamide (an antiepileptic drug), or Oxcarbazepine (an anticonvulsant drug), depending on your seizure pattern, other health factors, and lifestyle needs. Any change must be gradual and supervised to avoid breakthrough seizures.

Regarding driving, most regions require a minimum seizure-free period before you can legally resume, commonly six to 12 months, though this varies by country or state. The countdown typically starts from your last seizure, so it is important to follow your neurologist’s guidance, maintain medication compliance, and avoid triggers such as sleep deprivation and excess alcohol.

I hope this information helps you.

Feel free to ask further queries.

Thank you.