‘Just Stop the Tablets’: Why Epilepsy Medication Should Not Be Stopped Suddenly

Advice to “just stop the tablets” can be dangerous. Antiseizure medicines are usually reduced gradually and only after an individual discussion of seizure recurrence risk, lifestyle, driving and, where relevant, SUDEP.

Stopping treatment is a clinical decision

NICE recommends discussing the benefits and risks of discontinuing antiseizure medication as part of ongoing care. After a person has been seizure-free for 2 years, an individualised assessment should be made before deciding whether medication can be withdrawn.

Withdrawal is usually gradual

If a decision is made to stop treatment, NICE advises agreeing a withdrawal plan. For most antiseizure medicines, reduction is typically spread over at least 3 months. Benzodiazepines and barbiturates are usually reduced more slowly because of withdrawal risk.

Multiple medicines are reduced one at a time

For people taking more than one antiseizure medicine, NICE recommends withdrawing them one at a time. If seizures recur, the previous dose reduction may need to be reversed and specialist advice sought.

Why social-media advice is not enough

A stranger online does not know your seizure type, EEG findings, imaging, medication history, other conditions or individual risk. Treatment decisions need that context.

Source

NICE NG217 — Principles of treatment, safety, monitoring and withdrawal