Patients should consult their physician before taking any additional prescriptions, over-the-counter medications, nutritional supplements or herbal remedies. Of particular concern to individuals taking seizure medications are:

• Other seizure medications. Most seizure medications interact with other seizure medications. This may decrease the effectiveness of either (or both) medications or produce severe side effects. For people undergoing polytherapy (treating epilepsy with more than one seizure medication) it is important that any side effects or increase in number of seizures are reported to a physician.
  
  
• Alcohol. Drinking alcohol is not recommended for people who are taking seizure medications to control seizures. Alcohol can increase the likelihood of experiencing certain side effects such as dizziness and drowsiness. Alcohol can also decrease the effectiveness of many seizure medications, and increase the risk of having a seizure.
  
  
• Oral contraceptives. Many seizure medications adversely interact with oral contraceptives and may reduce the effectiveness of both. Women who are taking oral contraceptives are advised to discuss alternative contraceptive methods with their physician.
  
  
• Antidepressants. People who take antidepressants should consult with their physician about which seizure medications to take. Some antidepressants can reduce the effectiveness of certain seizure medications (e.g., carbamazepine, phenytoin, phenobarbital).
  
  
• Grapefruit juice. Grapefruit juice interferes with the liver’s ability to rid the body of some substances. This could cause seizure medications to build up to toxic levels in the body. While the buildup is less likely if the juice is ingested four or more hours prior to the medication, patients taking seizure medications are advised to refrain from drinking grapefruit juice at all. There is no indication that eating grapefruit (as opposed to drinking juice) presents any risk of adverse effects to patients.

The seizure medication carbamazepine interacts with certain antibiotics (e.g., erythromycin) by raising the levels of carbamazepine in the blood. The seizure medication phenytoin is known to interact with a wide variety of medications including antibiotics, ibuprofen, lithium and corticosteroids.

Additionally, some seizure medications can interact with certain vitamins and herbal medications, decreasing the effectiveness of the seizure medication. Patients are advised to consult their physician regarding supplements and interactions with their seizure medication.