What Medication Is Used for Seizures and Anxiety? A Comprehensive Guide

October 12, 2025 •

4 min read

According to a 2018 study, many individuals with epilepsy also experience anxiety, with estimates showing that anxiety is twice as likely to develop in people with epilepsy. In these cases, it is crucial to understand what medication is used for seizures and anxiety to address both conditions effectively.

Quick Summary

Certain medications, like benzodiazepines and specific anticonvulsants, can effectively treat both seizures and anxiety by calming nervous system activity. Choosing the right treatment involves weighing the benefits against potential risks and side effects.

Key Points

Dual Action Medications: Certain medications, such as benzodiazepines and specific anticonvulsants (AEDs), can treat both seizures and anxiety by calming the central nervous system.
Benzodiazepines for Short-Term Use: Benzodiazepines like clonazepam and diazepam are effective for managing acute anxiety and emergency seizures but carry risks of dependence and are not recommended for long-term use.
Anticonvulsants for Long-Term Management: Anticonvulsants such as pregabalin and gabapentin are often used for the long-term management of both seizures and anxiety, providing a safer alternative to benzodiazepines for chronic use.
Individualized Treatment Plan: The most effective treatment strategy depends on the patient's specific conditions, response to medication, and potential side effects, emphasizing the need for professional medical consultation.
Holistic Approach: Combining medication with psychotherapy (like CBT), relaxation techniques, and lifestyle changes is key for comprehensive management of co-occurring seizures and anxiety.
Off-Label Usage: Be aware that some medications used for anxiety in people with epilepsy, such as gabapentin, may be prescribed for off-label purposes.
Side Effect Management: Understanding and monitoring potential side effects, including drowsiness, dizziness, and mood changes, is a critical part of managing dual treatment.

Living with both seizures and anxiety presents a unique challenge, as the two conditions often coexist. The unpredictability of seizures can heighten anxiety, while underlying neurochemical imbalances can contribute to both disorders. Fortunately, some medications are effective for both conditions, offering a more streamlined treatment approach. The key lies in understanding the different drug classes and their respective risks and benefits.

Benzodiazepines for Seizures and Anxiety

Benzodiazepines are a class of central nervous system (CNS) depressants that are well-known for their anxiolytic (anti-anxiety) and anticonvulsant properties. They work by enhancing the effect of the neurotransmitter gamma-aminobutyric acid (GABA), which helps to calm the brain's nerve signals. While highly effective for short-term use, their potential for dependence and misuse necessitates careful management, especially for long-term treatment.

Common benzodiazepines for dual treatment

Clonazepam (Klonopin): Approved to treat both seizures and panic disorder, this medication is a long-acting benzodiazepine.
Diazepam (Valium): Used to treat seizures and anxiety, diazepam is also prescribed for alcohol withdrawal and muscle spasms. It is particularly effective for stopping prolonged or cluster seizures in emergency situations.
Clobazam (Onfi): This medication is specifically approved as an adjunct therapy for seizures related to Lennox-Gastaut syndrome and also has proven anti-anxiety effects.
Lorazepam (Ativan): Primarily used for anxiety, lorazepam is also a first-line treatment for convulsive status epilepticus, a medical emergency involving continuous seizures.

Risks and Side Effects of Benzodiazepines While powerful, benzodiazepines carry significant risks. Long-term use can lead to tolerance and dependence, and sudden withdrawal can trigger severe seizures. Common side effects include drowsiness, dizziness, confusion, and impaired coordination. The risk of respiratory depression is also heightened, especially when combined with alcohol or opioids.

Anticonvulsants with Anxiolytic Properties

Certain antiseizure medications (ASMs), often referred to as anticonvulsants, have demonstrated effectiveness in treating anxiety, though some uses may be considered "off-label". These medications provide an alternative for patients who need to manage both conditions but want to avoid the dependency risks associated with long-term benzodiazepine use.

Notable anticonvulsants for dual treatment

Pregabalin (Lyrica): Approved to treat partial seizures and generalized anxiety disorder (GAD), pregabalin works by reducing the release of excitatory neurotransmitters. It is a well-studied option for dual treatment.
Gabapentin (Neurontin): While FDA-approved for partial seizures and nerve pain, gabapentin is frequently used off-label for anxiety. It is thought to enhance the effects of GABA and provide a calming effect on the nervous system.
Valproate (Depakote): This medication class is effective for both generalized and focal seizures and can also have mood-stabilizing and anxiety-reducing properties.
Lamotrigine (Lamictal): Used for focal onset and generalized seizures, lamotrigine can also have mood-stabilizing effects that benefit patients with comorbid anxiety.

Considerations for Anticonvulsant Therapy Like any medication, anticonvulsants can cause side effects. Common ones include dizziness, fatigue, and weight changes. Some, like valproate, carry a risk of liver damage and may require routine blood monitoring. A potential risk of increased suicidal thoughts and behavior is also a warning associated with all antiseizure medications.

Comparison of Medications for Seizures and Anxiety


Feature	Benzodiazepines	Anticonvulsants (e.g., Pregabalin, Gabapentin)
Mechanism	Enhance GABA neurotransmission, calming the CNS	Modulate calcium channels or GABA-related pathways, reducing neuronal excitability
Speed of Action	Fast-acting; provides rapid relief for anxiety and emergency seizures	Slower onset, often taking weeks to show sustained effect for anxiety
Dependence Risk	High potential for tolerance and dependence with long-term use	Lower risk of physical dependence compared to benzodiazepines
Typical Use	Short-term anxiety management, emergency seizure control	Long-term management of chronic anxiety and epilepsy
Primary Side Effects	Drowsiness, dizziness, impaired coordination, respiratory depression	Dizziness, fatigue, weight gain, blurred vision
Off-Label Use for Anxiety	Often standard care	Gabapentin is off-label, Pregabalin is FDA-approved for GAD

Lifestyle and Therapeutic Strategies

Beyond medication, effective management of comorbid seizures and anxiety requires a comprehensive approach. Psychotherapy, particularly Cognitive Behavioral Therapy (CBT), can help individuals develop coping mechanisms and change negative thought patterns. Relaxation techniques, such as meditation and deep breathing, can also be beneficial in reducing stress and anxiety. For some, lifestyle changes like regular exercise, a balanced diet, and consistent sleep patterns can improve overall mental and physical well-being. Support groups, where individuals can connect with others who understand their challenges, provide a sense of community and can significantly reduce feelings of isolation.

For those with epilepsy, having a clear epilepsy action plan can ease fears and establish a protocol for managing seizures, which in turn helps reduce anxiety related to their unpredictability.

Conclusion

Treating comorbid seizures and anxiety often involves selecting medications that address both conditions simultaneously, such as certain benzodiazepines and anticonvulsants like pregabalin or gabapentin. While benzodiazepines offer rapid relief, their potential for dependence makes them less suitable for long-term use compared to certain anticonvulsants. A thorough discussion with a healthcare provider is essential to determine the most appropriate treatment plan, considering the patient's specific seizure type, anxiety severity, and individual risk factors. A holistic strategy that incorporates medication, therapy, and lifestyle adjustments is typically the most effective approach for managing these complex conditions and improving a patient's overall quality of life. For more detailed information on seizure medication side effects, please visit the Epilepsy Foundation website.

Frequently Asked Questions

No, not all anti-seizure medications are effective for anxiety. While some, like benzodiazepines, pregabalin, and gabapentin, have dual-action properties, others may have neutral or even negative psychotropic effects.

Long-term use of benzodiazepines is not generally recommended due to a high risk of tolerance, physical dependence, and potential for misuse. They are typically reserved for short-term anxiety management or emergency seizure control.

Common side effects can include drowsiness, dizziness, fatigue, weight changes, blurred vision, and stomach upset. Side effect profiles vary between different drugs and individuals.

Gabapentin (Neurontin) is approved for seizures and often used off-label for anxiety. While some studies show its effectiveness for anxiety, it is generally not a first-line treatment, and its use should be discussed with a doctor.

Yes. Non-medication options include psychotherapy (like Cognitive Behavioral Therapy), relaxation techniques (meditation, deep breathing), support groups, regular exercise, and maintaining a healthy diet and sleep schedule.

If you or a loved one experience suicidal thoughts while on any antiseizure medication, you should contact a healthcare provider immediately. An FDA warning notes a low but present risk of suicidal ideation with these drugs.

Open and honest communication is crucial. Telling your doctor about your anxiety, along with any other symptoms, helps them tailor a comprehensive treatment plan that addresses all of your needs, including evaluating medications with dual benefits.

Yes, some antiseizure medications, such as levetiracetam and topiramate, can potentially have negative psychotropic effects and worsen anxiety in some individuals.

Combination therapy is often more effective because medication can address underlying neurochemical imbalances, while therapy provides coping strategies and tools for managing the psychological and emotional aspects of anxiety and living with seizures.

While both can have anticonvulsant properties, they differ in mechanism, onset, and dependence risk. Benzodiazepines are fast-acting CNS depressants with a higher risk of dependence, whereas many anticonvulsants have a slower onset and lower dependence risk for chronic management.