Long-Term Use of Antiepileptic Medication: Risks and Considerations

Q: Long-Term Use of Antiepileptic Medication: Risks and Considerations

Hello： Based on your description, Shunao capsules primarily act as a relaxant for cerebral blood vessels, and the medication does not have effects for stroke prevention or epilepsy treatment. <br>Clinically, it is mainly used for treating migraines or dizziness. <br>Long-term use

Dizziness and epilepsy issues?

Hello Doctor: About 3.4 years ago, I fainted unconsciously and had a motorcycle accident.
At that time, the doctor diagnosed me with epilepsy and mentioned that there was a missing segment of a blood vessel in my right brain (cerebrovascular disease).
I was prescribed 10 mg of a brain-protective capsule to take once daily.
I haven't returned for follow-up visits since then, and I have been taking the medication without any issues.
Can I take this medication long-term? Will there be any side effects?

Pang Mami, 50~59 year old female. Ask Date: 2020/03/31

Dr. Jiang Junyi reply Neurology

Hello: Based on your description, Shunao capsules primarily act as a relaxant for cerebral blood vessels, and the medication does not have effects for stroke prevention or epilepsy treatment.
Clinically, it is mainly used for treating migraines or dizziness.
Long-term use may lead to mild side effects such as weight gain or abnormal movements.
I am unsure if you are a patient with metabolic syndrome (characterized by abdominal obesity, hypertension, elevated fasting blood glucose, and high blood pressure); if so, it is important to be aware of the risk of stroke (cerebrovascular disease?).
I recommend undergoing examinations for brain and vascular diseases.
For nerve repair, it is suggested to supplement with B vitamins.
I recommend consulting a neurologist to discuss examinations and treatment; however, due to the recent COVID-19 pandemic, it is advisable to wait until the situation stabilizes before going to the hospital for examinations.
Additionally, please ensure self-protection and hygiene measures before and after seeking medical care.
Wishing you good health, safety, and happiness.
Dr.
Jiang, Department of Neurology, Taoyuan Hospital, cares for you.

Reply Date: 2020/03/31

More Info

Long-term use of antiepileptic medications, such as the one you mentioned (舒腦膠囊, which is likely a brand name for an antiepileptic drug), can be a complex issue that requires careful consideration of both the benefits and potential risks. Antiepileptic drugs (AEDs) are essential for managing epilepsy and preventing seizures, but they can also have side effects, especially when used over extended periods.

Safety of Long-Term Use
1. Efficacy vs. Side Effects: The primary goal of antiepileptic medication is to control seizures effectively. If your medication is working well and you are seizure-free, this is a positive outcome. However, long-term use can lead to various side effects that may affect your quality of life.

2. Common Side Effects: Some common side effects of long-term antiepileptic drug use can include:
- Cognitive Impairment: Some patients report difficulties with memory, attention, and overall cognitive function. This is particularly concerning for younger patients or those in their developmental years.

- Mood Changes: Some AEDs can lead to mood swings, depression, or anxiety.

- Physical Side Effects: These may include dizziness, fatigue, weight gain or loss, and coordination problems.

- Organ Function: Long-term use can sometimes affect liver function or lead to blood disorders, so regular monitoring is essential.

3. Bone Health: Long-term use of certain AEDs has been associated with decreased bone density, increasing the risk of fractures. This is particularly important for older adults or those with other risk factors for osteoporosis.

4. Withdrawal Risks: If you decide to stop taking your medication, it is crucial to do so under medical supervision. Abrupt discontinuation can lead to withdrawal seizures, which can be dangerous.

Monitoring and Consultation
Given your history of seizures and the fact that you have been on medication for several years, it is essential to have regular follow-ups with your healthcare provider. They can monitor your health, adjust your medication if necessary, and help manage any side effects you may experience.

1. Regular Check-ups: Schedule regular appointments to discuss your medication, any side effects, and overall health. Blood tests may be necessary to monitor liver function and blood counts.

2. Lifestyle Considerations: Maintaining a healthy lifestyle can help mitigate some side effects. This includes a balanced diet, regular exercise, and avoiding alcohol and recreational drugs, which can interact negatively with AEDs.

3. Educate Yourself: Understanding your condition and the medications you are taking can empower you to make informed decisions about your health. Don't hesitate to ask your doctor questions about your treatment plan.

Conclusion
In conclusion, while long-term use of antiepileptic medications can be necessary and beneficial for controlling seizures, it is essential to remain vigilant about potential side effects and to maintain open communication with your healthcare provider. Regular monitoring and lifestyle adjustments can help manage risks associated with long-term medication use. If you have concerns about your current treatment or experience any side effects, please consult your doctor for personalized advice and potential adjustments to your treatment plan.

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