SEIZURES 239
OTHER DRUGS SOMETIMES USED FOR EPILEPSY
• Primidone (Mysoline) For all seizures. Start with low doses and gradually increase to 10 to
25 mg./kg./day in 2 to 4 divided doses. May cause sleepiness, dizziness, vomiting, or rash.
• Ethosuximide (Zarontin) First choice for ‘minor seizures’ with blank staring, eye-fluttering,
and perhaps strange motions—especially if the seizures occur in groups in the morning
and evening. Give 10 to 25 mg./kg./day in 1 or 2 doses, with food to avoid stomach
ache. Rarely causes liver damage.
• Valproic acid (Depakene) Used alone or in combination with other anti-seizure drugs, except
carbamazepine, for ‘minor seizures’ with blank staring or ‘absences,’ especially when the
seizures occur in groups. For children between 1 and 12 years. The dosage for a child who
weighs up to 20 kg. is initially 20 mg./kg./day in 2 to 3 divided doses. (For example, a child
weighing 10 kg. would take 200 mg. a day, and a child weighing 20 kg. would take 400 mg.
a day.) Children over 20 kg can start with 400 mg. a day in divided doses, and the dose can
be increased until the seizures are controlled (usually up to 30 mg./kg./day). Never give more
than 60 mg./kg./day. Few side effects. May cause liver damage, so monitor liver function for
the first 6 months, especially for children younger than 3 years old.
• Corticosteroids (or corticotropin) These are sometimes tried for ‘baby spasms’ and ‘jolt
seizures’ (see p. 240) that are not controlled by other medicines. Long-term use of these
medicines causes serious and possibly dangerous side effects (see p. 137). They should be
used only with highly skilled medical advice when all other possible medicines have failed.
• Diazepam (Valium) Sometimes used for ‘newborn seizures’ or ‘baby spasms’ (see p. 240),
but other medicines should be tried first. May cause sleepiness or dizziness. Mildly habit
forming. Give about 0.2 mg./kg./day in divided doses.
CAUTION DURING PREGNANCY: Many of the anti-seizure drugs, especially phenytoin, may
increase the risk of birth defects when taken by pregnant women. Also, some of the drug goes into
breast milk. Therefore, pregnant women should use these drugs only when seizures are common or
severe without them. Women taking seizure medicine should not breast feed if they are able to feed
their babies well without breast milk. Phenobarbital is probably the safest anti-seizure medicine
during pregnancy.
treatment for a long-lasting seizure
When a seizure has lasted more than 15 minutes:
• if someone knows how, inject IV diazepam (Valium) or phenobarbital into the vein.
CAUTION: Diazepam and phenobarbital must both be injected very slowly. For diazepam, take at
least 3 minutes to inject the dose for children. For phenobarbital, inject children at the rate of 30 mg./
minute or slower, and in adults, not more than 100 mg./minute.
Doses for injectable diazepam:
Adults . . . . . . . . . . . . 5 to 10 mg.
Children 7-12 years . . . . . 3 to 5 mg.
Children under 7 . . . . . . 1 mg. for
every 5 kg. of body weight.
Doses for injectable phenobarbital:
Adults . . . . . . . . . . . . . 200 mg.
Children 7-12 years . . . . . . 150 mg.
Children 2-6 years . . . . . . . 100 mg.
Children under 2 years . . . . . 50 mg.
• or put a ‘suppository’ of diazepam, paraldehyde, or phenobarbital up the rectum
(asshole).
NOTE: These medicines do not work as fast or
well when they are injected into a muscle. If
you only have injectable or liquid medicine,
put it up the rectum with a plastic syringe
without a needle. Or grind up a pill of
diazepam or phenobarbital, mix with water,
and put it up the rectum.
Putting diazepam
up the rectum
(without a needle!)
works faster than
injecting it into a
muscle.
If the seizure does not stop in 15 minutes after giving the medicine, repeat the dose.
Do not repeat more than once.
disabled village children