Seizure Rescue Therapies

Seizure rescue therapies are medications or treatments used as needed, to stop seizures quickly and prevent emergencies. Rescue therapies do not take the place of daily seizure medication. Not all people with epilepsy have seizure emergencies or need rescue therapies. Talk with your healthcare provider about your seizure action plan or acute seizure action plan and whether you need a rescue medication.
What are rescue medications?
Rescue medications (or rescue treatments) are only given in specific situations. They are also called “as needed” medications.
The ideal rescue medicine:
- Is easy to use
- Works quickly
- Is safe with few to no side effects
- Is effective at stopping seizures
The goal is to stop seizures quickly to prevent emergency situations, and hopefully prevent going to the emergency room. Rescue medications do NOT take the place of emergency medical care. Emergency medical help should be obtained quickly when needed.
Rescue treatments do NOT take the place of daily seizure medications. Most people diagnosed with epilepsy are prescribed daily anti-seizure medications.
What Are Seizure Rescue Therapies?
Dr. Korwyn Williams and Dr. Wendy Trueblood Miller talk about what seizure rescue therapies are and how to stay prepared. This video clip is from the webinar Back to School Success: Ensuring Safety for Students with Epilepsy.
Learn More:
Importance of Medication SchedulesSome people have implanted devices for the treatment of epilepsy.
Examples include:
- Vagus nerve stimulator (VNS)
- Responsive neurostimulator (RNS)
- Deep brain stimulator (DBS)
These devices may be used as a rescue therapy option by swiping a magnet over the generator.
What types of medicines can be used as a rescue treatment?
The most common type of rescue medications are known as benzodiazepines. These medications get into the bloodstream and then into the brain quickly. Benzodiazepines most commonly used as rescue medications include diazepam, lorazepam, clonazepam, and midazolam.
They are available in several different forms. Depending on the medication, they can be:
- Sprayed into the nose (nasal)
- Given via a gel into the rectum (rectal)
- Placed under the tongue to dissolve (sublingual)
- Placed between the cheek and the gum to dissolve (buccal)
- Swallowed in pill form (oral)
In the hospital, benzodiazepines can be given by an infusion directly into the vein or injected into a muscle.
These medications are available in different forms and by different names in different countries. The brand names of these medications may change depending on the form prescribed.
In the United States, the U.S. Food and Drug Administration (FDA) has approved several medications for out-of-hospital use for the treatment of acute repetitive seizures or seizure clusters. These include:
- Diastat® - a diazepam rectal gel
- Nayzilam® - a midazolam nasal spray
- Valtoco® - a diazepam nasal spray
Other medications have been used as out-of-hospital rescue treatments for seizures clusters but are not approved by the FDA at this time.
Learn More:
Seizure Medication ListHow do I choose the right seizure rescue therapy?
When you create your seizure action plan with your healthcare provider, you can choose a rescue therapy, if you need one. The action plan outlines seizure first aid, instructions for rescue medication, and when to call for emergency help.
Things to consider when talking to your provider about a rescue medication:
- How fast will it work?
- How will I take it? (nose, cheek, mouth, or rectal)
- How easy is it to use?
- What are the side effects?
- How much does it cost?
People who remain awake and alert may be able to use either a nasal spray or swallow a pill. Other people who are not alert may need a form that can be sprayed into a nostril (nasal spray), given under the tongue (sublingual), or between the cheek and gum (buccally).
People who are not able to take these forms or who are not alert can be given rectal diazepam. However, this is most often prescribed for infants and young children.
When should seizure rescue therapies be used?
Not all people with epilepsy have seizure emergencies and may not need to use any treatment other than their regular daily seizure medications. Sometimes seizures occur in a different pattern that is more frequent or more severe. These patterns are called seizure clusters or acute repetitive seizures. Stopping seizures early in these situations is the key to preventing a seizure emergency.
There is no one-size-fits-all when it comes to rescue therapy. Since each person’s seizures are different, their seizure action plan or acute seizure action plan should be made specifically for them.
When going to the doctor:
- Describe your typical seizure pattern and how you recognize it.
- If you keep a seizure diary, share it with your healthcare provider to help recognize any patterns.
- Ask if rescue medications are right for you and develop a clear plan with your provider about when they should be used, and if the dose can be repeated if the first one does not work.
Rescue medications may be recommended when:
- Seizures occur that differ from your usual type or pattern.
- Seizures occur more frequently than usual.
- Seizures last longer than typical events.
- Seizure cluster patterns are different than usual – for example, when the seizures within the cluster are longer than normal or the intervals between them are shorter than normal.
- Seizures occur at high-risk times – for example, during medication changes, when sick, or with airplane travel across multiple time zones.
Webinar Recording
Rescue Therapies for Children and Adults
Watch the video for a discussion with Dr. Lawrence Hirsch and registered nurse Nancy Santilli about the latest options in rescue therapies for children and adults.
Webinar recorded on September 1, 2022
Rescue Therapies for Children and Adults
In this webinar recording, experts discuss the latest options in rescue therapies for children and adults.
Resources
Epilepsy Centers
Epilepsy centers provide you with a team of specialists to help you diagnose your epilepsy and explore treatment options.
Epilepsy Medication
Find in-depth information on anti-seizure medications so you know what to ask your doctor.
Epilepsy and Seizures Helpline
Call our Epilepsy and Seizures Helpline and talk with an epilepsy information specialist or submit a question online.
Tools & Resources
Get information, tips, and more to help you manage your epilepsy.