How do I manage my seizures at 28?

Question

Hi doctor,

I am 28 and started having seizures seven months ago with absolutely no family history, and it has been terrifying and completely life-altering.

My first tonic–clonic seizure happened while I was driving, causing an accident thankfully without serious injuries to anyone involved. The neurologist prescribed levetiracetam, which controls most of the seizures but causes severe mood changes, intense irritability, and aggressive behavior that has scared my fiancée away from me.

The medication seems to prevent seizures, but the psychiatric side effects are tearing my relationship and my life apart. I lost my driving privileges after the seizure, which makes getting to work extremely difficult, and I feel trapped without independence.

The constant anxiety about when the next seizure might occur is overwhelming, and I am afraid to be alone or participate in normal activities. Sleep deprivation from worry seems to trigger more seizure activity, creating a vicious cycle of fear and symptoms.

My neurologist wants to add Lamotrigine as a second medication, but I am extremely concerned about additional side effects and drug interactions.

My MRI and prolonged EEG monitoring have not identified any structural cause, which makes everything feel even more unpredictable and frightening for my future.

My fiancée is questioning whether we should postpone the wedding because she is scared of the anger and irritability caused by the medication. Are there alternative anti-seizure medications with significantly fewer psychiatric side effects? I desperately need seizure control without personality changes that destroy my relationships.

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Seizures themselves are frightening enough, and when the medication affects mood and relationships, everything becomes even harder. Levetiracetam is an effective seizure medicine, but in some people it can cause irritability, anger, anxiety, or mood swings. These are well-known side effects and not your fault; it is your brain reacting to the drug, not you changing as a person. Sometimes these emotional symptoms improve with a dose adjustment or by adding a small amount of vitamin B6 (Pyridoxine 50 to 100 mg daily), though you should ask your doctor before trying this, as it helps some patients.

There are several anti-seizure medications that tend to have a gentler mood profile. Lamotrigine often improves mood rather than worsening it and is commonly used when Levetiracetam causes irritability. It must be started very slowly to avoid rash, but once established, it is one of the most balanced and well-tolerated options. Other alternatives include Lacosamide, Oxcarbazepine, Brivaracetam, or Valproate, although Valproate is usually avoided in young women who may become pregnant. Your neurologist will decide the best choice based on your seizure type, age, and lifestyle needs.

The anxiety and fear of another seizure are extremely common in new-onset epilepsy. Counseling or cognitive-behavioral therapy can help reduce this fear and rebuild confidence. Many people also benefit from relaxation techniques and maintaining consistent sleep routines, which can help prevent seizure triggers.

Driving restrictions are temporary in most regions, and you can usually resume driving after remaining seizure-free for the required period, often six to twelve months, once your doctor confirms your stability. This can help restore a sense of independence once your seizures are better controlled.

It may also help to explain to your fiancée that your mood changes are a medical side effect, not a reflection of who you are. Including her in your medical appointments can help her understand the situation more clearly and feel more reassured and supported.

I hope this has helped you.

Please feel free to reach out to me again for further queries.

Thank you.