Vimpat alternatives: What can I take instead of Vimpat?

Compare Vimpat alternatives | Tegretol | Lamictal | Keppra | Trileptal | Topamax | Natural alternatives | How to switch meds

Epilepsy is a neurological disorder characterized by chronic seizures. During a seizure, electrical activity in the brain becomes unbalanced, leading to uncontrolled movements, changes in sensation or cognition, and impaired awareness.  

Vimpat is a brand-name prescription drug used to treat certain types of seizures. It’s approved by the Food and Drug Administration (FDA) for the treatment of partial-onset seizures in patients one month of age or older and as adjunctive therapy for the treatment of primary generalized tonic-clonic seizures in patients four years of age or older. The active ingredient in Vimpat is lacosamide, which belongs to a class of drugs known as anticonvulsants. Vimpat works by inactivating sodium channels in the brain to stabilize electrical impulses between nerve cells, thereby preventing seizures. Vimpat is available as a tablet, oral solution, and injection.

While Vimpat can help control seizures, it may not be suitable for everyone. Patients with heart disease or heart failure should use Vimpat with caution because it can cause heart rhythm problems. Other common side effects such as dizziness, double vision, sleepiness, and problems with coordination can also occur. Alternative anticonvulsants are available for patients who experience these Vimpat adverse effects or for those wanting to try another treatment option.

What can I take in place of Vimpat?

There are many types of anticonvulsants that can be used for seizure control. These medications may target different chemical receptors, but in general, they all work by stabilizing electrical activity in the brain. The choice of anticonvulsant can depend on the type of seizure being treated, the side effects of the drug, and the dosage. Common alternatives of Vimpat for the treatment of partial-onset and tonic-clonic seizures are listed below.

Other alternatives to Vimpat

• Aptiom (eslicarbazepine)
• Benzodiazepines:
  • Ativan (lorazepam)
  • Klonopin (clonazepam)
  • Tranxene-T (clorazepate)
  • Valium (diazepam) 
• Briviact (brivaracetam)
• Carbatrol (extended-release carbamazepine)
• Cerebyx (fosphenytoin) 
• Depakote ER (extended-release divalproex)
• Epitol (carbamazepine)
• Felbatol (felbamate)
• Fycompa (perampanel)
• Keppra XR (extended-release levetiracetam)
• Lamictal XR (extended-release lamotrigine)
• Mysoline (primidone)
• Oxtellar XR (extended-release oxcarbazepine)
• Sabril (vigabatrin) 
• Spritam (levetiracetam tablets for oral suspension)
• Tegretol XR (extended-release carbamazepine)
• Trokendi XR (extended-release topiramate)
• Xcopri (cenobamate)

Top 5 Vimpat alternatives

1. Tegretol (carbamazepine)

Tegretol is an anticonvulsant medication used to treat complex partial seizures, generalized tonic-clonic seizures, and mixed seizure patterns. Tegretol is available in multiple dosage forms, including tablets, extended-release tablets, and a suspension. For adults and children over 12 years of age, the initial dose for tablets is 200 mg twice daily and gradually increased in weekly intervals.

Common side effects of Tegretol include nausea, vomiting, dizziness, drowsiness, dry mouth, and problems with coordination. Rarely, Tegretol can also cause serious skin reactions, low blood cell counts, liver damage, and low sodium levels. Patients starting Tegretol may need to complete blood tests to monitor for these adverse effects. Taking Tegretol with other medications can lead to multiple drug interactions, and patients should tell their prescribing healthcare provider about all prescription, over-the-counter, and herbal products being taken before starting Tegretol.     

2. Lamictal (lamotrigine)

Lamictal is a Vimpat alternative approved for the treatment of partial seizures, primary generalized tonic-clonic seizures, and generalized seizures of Lennox-Gastaut syndrome. Lamictal can be used in combination with other antiepileptic drugs such as valproic acid, Tegretol, Dilantin, phenobarbital, or Mysoline. The dose of Lamictal depends on which anticonvulsant it’s used with, but Lamictal is usually started at a low dose that is increased weekly.

Lamictal causes some common side effects such as rash, impaired coordination, dizziness, double vision, blurred vision, drowsiness, nausea, and vomiting. Skin rashes requiring hospitalization are a rare but serious side effect of Lamictal most often occur between two and eight weeks after starting the medication. Lamictal should not be taken by anyone that has demonstrated hypersensitivity to the drug or its ingredients.

3. Keppra (levetiracetam)

Keppra is another anticonvulsant indicated for the treatment of partial seizures, myoclonic seizures in patients with juvenile myoclonic epilepsy, and primary generalized tonic-clonic seizures. Both oral and intravenous dosage forms are available. Keppra tablets are started at a dose of 500 mg twice daily for adults.

Taking Keppra can affect the central nervous system (CNS), leading to side effects of drowsiness, tiredness, headache, dizziness, and irritability. In clinical trials, 1% of adult patients taking Keppra also experienced psychotic symptoms. However, most psychiatric reactions are mild. Compared to Vimpat and other anticonvulsants, Keppra has fewer drug interactions and does not significantly influence the levels of other drugs in the body. 

4. Trileptal (oxcarbazepine)

Both Vimpant and Trileptal belong to the anticonvulsant drug class and are used to treat partial seizures. Trileptal can be used as monotherapy or as adjunctive therapy. Trileptal is available in oral dosage forms as a tablet and suspension, while an extended-release version is available as Oxtellar XR. When taken as monotherapy, the initial dose is 300 mg twice daily for adults.

The active ingredient in Trileptal—oxcarbazepine—is a derivative of carbamazepine, and both drugs share similar side effects. A potentially serious reaction of Trileptal is low sodium levels, and patients taking Trileptal may need to receive regular blood tests to monitor their sodium levels, especially if other sodium-lowering drugs are taken at the same time. Trileptal can also lower the effectiveness of hormonal contraceptives. 

5. Topamax (topiramate)

Topamax is another anticonvulsant option for epilepsy patients. It is indicated as monotherapy or adjunctive therapy for the treatment of partial seizures and primary generalized tonic-clonic seizures and only as adjunctive therapy for seizures associated with Lennox-Gastaut syndrome. Topamax is also commonly prescribed for migraine headaches. A dosing schedule with weekly dose increases is preferred to reduce side effects.

Common side effects of Topamax include drowsiness, dizziness, memory problems, weight loss, and tingling. More serious side effects are secondary angle closure glaucoma, kidney stones, increased body temperature, and acid buildup in the body (metabolic acidosis). Exposure to Topamax during pregnancy can lead to birth defects. Patients taking Topamax who are pregnant or planning to become pregnant should inform their doctor immediately.

Natural alternatives to Vimpat

Besides prescription medications, there are also natural alternatives to Vimpat that can help improve epilepsy. These non-drug options include the following vitamins, herbal remedies, and diet modifications.

Ketogenic diet

The ketogenic diet is a special dietary therapy consisting of high-fat and low-carbohydrate foods. This diet induces metabolic changes in the body as fats are primarily used for fuel instead of carbohydrates. Studies have shown that the ketogenic diet is effective for seizure control, particularly in children with drug-resistant epilepsy. A greater than 50% reduction in seizures was observed in 56% of children on the diet.

Vitamins

Some people with epilepsy may have lower levels of certain vitamins such as vitamin B6, folic acid, vitamin D, and vitamin E. In particular, vitamin B6 deficiency can be a cause of uncontrolled seizures in infants and children. Supplementation with vitamins may help manage seizures, but more studies are needed to fully understand their effects. 

Herbs

Herbal remedies have been used by different cultures around the world to treat epilepsy. Some herbs for seizures include valerian, passion flower, black cohosh, Bacopa monnieri, melatonin, and ashwagandha. However, there are not many studies showing the scientific evidence behind these herbal medicines, and they should be used under a doctor’s guidance.  

How to switch to a Vimpat alternative

Safely switching to a Vimpat alternative requires close communication between you and your healthcare provider. Switching anticonvulsants usually involves starting the new medication at a low dose while gradually withdrawing Vimpat. It’s not safe to suddenly discontinue Vimpat due to the risk of seizure recurrence. 

Patients who are starting a new antiepileptic drug should follow the dosing schedule provided by their doctor. It’s also important to inform the doctor about any vitamins or herbal medicines being taken as these supplements can interact with prescription anticonvulsants. Patients who are concerned about the cost of their medication can use a SingleCare prescription discount card or coupon, which apply to multiple seizure medications.