. . . Helpful or Harmful?

In past centuries, before modern seizure medicines were developed, people with epilepsy looked for a remedy in various herbs and combinations of herbs. Occasionally they found one that seemed to help. Unfortunately, when we try these remedies today, they are hardly ever as effective as the medicines our doctor prescribes. Some even make us worse, either directly, by lowering our seizure threshold, or indirectly, by interacting with our prescription medications. Some herbal medicines do seem to be helpful in certain situations, but herbal medicines are not necessarily safer just because they're "natural."

This is not to say that if you have epilepsy you must avoid every herb, down to that little piece of parsley on the side of your plate. There are hundreds of possible herbal remedies, and our knowledge of their effects is far from complete. Testing a potential medication in a controlled way in a large number of people is an expensive venture. Little research of this kind has been done with herbs.

Why is it hard to use herbs to treat epilepsy?

Even when we do have some information on a particular herb, it can be difficult to apply because the forms, dosages, and combinations in which herbs are sold are not well standardized in the United States. As long as the manufacturer does not claim that the herb will cure or prevent a particular medical condition, the Food and Drug Administration (FDA) considers it a "dietary supplement" and regulates it much less strictly than other medications.

A complicating factor is that people with epilepsy may experience undesirable effects from an herb or herbal combination that is safe for most others. It appears that a few herbs (including some common ones) may directly increase the likelihood of seizures. Many others can interact with seizure medicines, either diminishing seizure control or worsening side effects. Of course the effect is different depending on what kind of seizures you have and what seizure medicines you take.

If I want to try, how should I start?

If you are thinking of trying an herbal medicine because you're dissatisfied with your current epilepsy treatment or because you've heard that it might help with some other problem like depression, memory loss, or PMS, read on. Educate yourself. When you are trying to figure out whether an herb is right for you, don't rely on claims made by somebody who is trying to sell you a pill or a powder. Search this site and other reputable sources for unbiased information about the herb, the disorder you want to treat, and all the other medicines you are taking. (One good source of information about many herbs is the website of the Integrative Medicine Service of the Memorial Sloan-Kettering Cancer Center, found at http://www.mskcc.org/mskcc/html/11570.cfm.)

Should I get the doctor involved?

Take the information that you gather to your doctor. If you're having seizures or unacceptable side effects, tell the doctor how you feel (remember to take your seizure calendar) and ask whether there's some other treatment that is likely to help you. When you say that you've been investigating an herbal medicine, the doctor should be willing to hear you out. Doctors also are trying to get educated about herbal products, so the doctor may or may not have more information about that herb.

If your doctor says that it's OK for you to use the herbal product alongside your regular seizure medicine, go ahead, but don't take more than the recommended dose. If you experience any new side effects, don't ignore them—call the doctor. And NEVER substitute an herbal medicine for your regular seizure medicine. If you do, you may wind up having life-threatening prolonged seizures called status epilepticus.

Each time you visit the doctor, be sure to give a complete report on every herb or other over-the-counter medication that you are taking. (The easiest way is to take all the bottles with you.) If you get advice from an herbalist, make sure that you also tell that person about all the prescription and nonprescription medicines that you take. A reputable herbalist will be aware of interactions that may be harmful.

Much of the information in this article is based on Spinella M: Herbal medicines and epilepsy: The potential for benefit and adverse effects. Epilepsy Behav 2001; 2(6):524-532. (PMID 12609386)

Topic Editor: Steven C. Schachter, M.D.
Last Reviewed:12/15/06