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NICE is an independent organisation
responsible for providing national guidance on promoting good health and
preventing and treating ill healthThe
NICE epilepsy clinical guideline covers the diagnosis, treatment and
management of epilepsy in children, young people, adults and older
people. The guideline makes recommendations for treatment and care
provided by GPs and by specialists.
It also makes recommendations
about when someone should be referred to a specialist centre (a clinic
or unit with particular experience and expertise in investigations or
treatment of epilepsy that is difficult to diagnose or treat – sometimes
called a tertiary centre).
Special considerations
concerning the care of women with epilepsy and people with learning
disabilities are covered.
(For details of the guidelines
or to order printed copies please visit the website at
www.nice.org.uk)
NICE has made the following
recommendations about the use of newer drugs to treat adults with
epilepsy.
If the older drugs (such as
sodium valproate and carbamazepine) do not stop a person from having
seizures, or if the person experiences side effects, one of the newer
drugs can be tried, as long as it is suitable for the type of epilepsy
the person has. Lamotrigine, oxcarbazepine and topiramate can be given
as the person’s only treatment for epilepsy. They can also be given with
another drug when that drug on its own does not stop a person’s seizures
(this is called combination therapy). Gabapentin, levetiracetam,
tiagabine and vigabatrin are generally used as combination therapy with
another drug.
A newer drug can also be tried
if the older drugs are unsuitable for the person. This could be because
there is a reason why he or she cannot take the older drugs (for
example, some drugs are not suitable for people with liver disease), or
because they cause unwanted effects that the person cannot tolerate. The
older drugs might also be unsuitable if they affect another drug the
person is taking (for example, some antiepileptic drugs make the
contraceptive pill work less well).Some antiepileptic drugs are
unsuitable for women with epilepsy who might become pregnant because
they might harm an unborn child.
NICE recommends that people
should be treated with just one antiepileptic drug where possible. If
the first drug doesn’t stop a person having seizures, another can be
tried. The person’s doctor will need to take special care when changing
over from one drug to another.
(For details of the guidelines or to
order printed copies please visit the website at
www.nice.org.uk)
If you have concerns that the care
or treatment you are receiving does not live up to the guidance
suggested please let us know.
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