What over-the-counter (OTC) supplements have antiseizure properties?

OTC Supplements with Antiseizure Properties

There are no FDA-approved over-the-counter supplements with proven antiseizure properties that can be recommended as primary treatment for epilepsy or seizure disorders. 1

Evidence-Based Overview

The current medical literature and guidelines provide limited evidence for OTC supplements as effective antiseizure agents. Most supplements lack rigorous clinical trials demonstrating efficacy for seizure control, and some may actually worsen seizure control or interact with prescribed antiseizure medications.

Supplements with Limited Evidence for Antiseizure Effects

• Vitamin E: One small study (24 participants) found a significant decrease in seizure frequency compared to placebo, but the evidence is insufficient to recommend routine use 2

• Melatonin: May have modest benefits for some seizure types, particularly in children with sleep disturbances, but is not considered a primary treatment 1

• Magnesium: Used as an adjunctive treatment during seizure management, particularly during the maintenance phase of targeted temperature management, but not as a standalone antiseizure agent 3

Potential Risks of Supplements in Seizure Disorders

Supplements That May Worsen Seizures

Several supplements can potentially lower seizure threshold or interact with antiseizure medications:

• St. John's Wort: Known to cause clinically important drug interactions with many medications including antiseizure drugs 4

• Ginkgo biloba: May lower seizure threshold in some individuals 5

• Ephedra-containing supplements: Can increase risk of seizures 5

• Ginseng: Some preparations may interact with antiseizure medications 4

Medication Interactions

People with epilepsy often take multiple medications, creating significant potential for drug-drug interactions:

• Nearly 25% of U.S. adults report concurrently taking prescription medications with dietary supplements 4

• 56% of people with epilepsy take other prescription or OTC medications alongside their antiseizure drugs 6

• Only 44% of patients consistently report their antiseizure medication use to other healthcare providers 6

Clinical Recommendations

1. Prioritize FDA-approved antiseizure medications:

   • 24 medications have similar efficacy for focal epilepsy
   • 9 medications have similar efficacy for generalized epilepsy 7

2. Always discuss supplement use with healthcare providers:

   • Disclose all supplements to neurologists and pharmacists
   • Be aware that supplements are not regulated with the same rigor as prescription medications

3. Avoid supplements known to lower seizure threshold:

   • Particularly those containing stimulants or ephedra

4. Consider vitamin D supplementation only for bone health:

   • One study found higher bone mineral content among patients with epilepsy taking antiseizure drugs with vitamin D supplementation compared to controls 2
   • This addresses a specific side effect of some antiseizure medications rather than treating seizures directly

Conclusion

The American Academy of Neurology and other professional organizations do not recommend OTC supplements as primary treatment for seizure disorders 1. Patients should be counseled that relying on supplements instead of proven antiseizure medications could lead to increased seizure frequency, bodily injuries, and higher mortality. The focus should remain on evidence-based treatments under proper medical supervision.