. . . Helpful or Harmful or We Don’t Know?

In past centuries before modern seizure medicines were developed, people with epilepsy and their doctors looked for a remedy in various herbs and combinations of herbs. Occasionally they found one that seemed to help. None of these remedies have been proven to be safe and effective. Unfortunately, some of them can make seizures worse by causing seizures, or by interacting with prescription seizure medications. Even though some herbal medicines are available as dietary supplements, they are not necessarily safe for people with epilepsy, 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, but it’s beginning to happen now. For example tests are being done on an ingredient that is related to medical marijuana, and another that comes from a Chinese moss plant.

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. 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 get 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 chance of seizures. Many others can interact with seizure medicines, either causing more seizures 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 am thinking about trying an herbal therapy, what can I do to learn more?

If you are thinking of trying an herbal medicine because you don't like your current epilepsy treatment or because you've heard that it might help with some other problem (like depression, sleep, 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 the manufacturer or a company that is trying to sell it to you.
  • 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.)

Should I get the doctor involved?

Definitely! 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 with your regular seizure medicine, go ahead, but don't take more than the recommended dose.
  • If you develop 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)

 

 

 

Authored by: Steven C. Schachter, MD | Patricia O. Shafer, RN, MN
Reviewed by: Joseph I. Sirven, MD | Patricia O. Shafer, RN, MN on 8/2013
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