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The Evolution of Epilepsy Treatment with Greg Grunberg & Barry Gidal, Pharm.D.

The new century has seen an incredible growth in new medications developed to help treat seizures. New therapies, including surgical techniques and dietary options, have also shown increased adoption and promise during the 21st century. If you are still struggling with seizure control, than you need to make sure you explore all the potential treatment options with your health care team — even one seizure is too many! New medications have much different tolerance levels to help improve quality of life by reducing or ending unwanted side effects. Surgery can now be done with very little invasion versus in the past when whole parts of the skull had to be removed. Devices that stimulate parts of the brain can help control or prevent seizures. Dietary therapies, like the ketogenic diet, have great success for some people. Make sure you know all your options and talk about them with your health care team.

Greg: If you have epilepsy and are not satisfied with your seizure control, there are more new medications and other therapies now than ever before.

Greg Grunberg: First tell me about the evolution of therapies. Where did it start, from the last couple decades until today?

Barry: You know, it's interesting. If you look at the development of any seizure medicines over the last few years… We went for a long time, almost 50 years, without a new drug. But then starting in the 1990s, with the decade of the brain, there was huge research, in looking at a variety of disorders involving epilepsy. So when you go from the mid 1990s on, there has been this explosion of new drugs. We're beginning to understand more about how these medicines work. You know, if we go back in time, we didn't really know how some of these anti-seizure medicines worked. It was hard to figure out how to make them better. 

Greg: Why was there that lapse in time, without new medications coming out?

Barry: Part of this was the technology, and partly the science of understanding exactly HOW we should be modifying medicines. But it was also the investment that was being made in basic fundamental research in the 1990s that made that possible. 

Greg: It also seems like it timed with the speed of computers, it seemed to be there was another incredible medication coming out. You hear about another one, or a therapy or whatever, and it gives you a lot of hope. My son Jake who has been dealing with it for 12 years, so we've really seen, in 12 years that huge leap forward. 

Barry: Well you know, as we get better and better understanding how these drugs work, and what kinds of effects they produce in different populations of patients, we can now begin designing drugs that work in different groups. And that's why with the Human Genome Project, and precision medicine, now we're beginning to look at the genetics, I think in the next decade there's going to be a whole new revolution in how we treat brain disorders.

Greg: Learn about the latest medications and treatments by visiting