Heres a list of important things to consider when deciding whether or not to stop a seizure medication: Duration of seizure freedom (longer seizure-free period, often 25 years, lowers recurrence risk) Type of epilepsy syndrome or seizure classification Age at seizure onset (childhood-onset epilepsies often have better remission rates) Presence of structural brain disease (tumor, stroke, traumatic brain injury, cortical malformation) Number of antiseizure medications required for seizure control (monotherapy vs polytherapy) Seizure frequency prior to achieving control Duration of epilepsy before remission occurred Patient safety considerations if a seizure were to recur (driving, occupational risks, injury risk) Adverse effects or medication burden (cognitive effects, drug interactions, bone health concerns, teratogenic risk) I also wanted to discuss individual agents when considering whether or not to taper seizure medications and how that is typically done
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