FND Education Project

REFERENCE · RECOVERY TECHNIQUE

Prescriber-Led Medication Review for Functional Seizures

Most likely fit: When antiseizure or rescue medication is being used and its indication, benefit or risks need clarification, especially if epilepsy may coexist. [Clinical guideline recommendation; no unsupervised withdrawal]

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Know what each medicine is for

A medicine called an antiseizure medicine may be prescribed for epilepsy or for another reason, such as a pain or mood condition. Ask the prescriber to explain its purpose before making a change. A diagnosis of functional seizures does not automatically mean every medicine should stop. [1]

The AAN guideline advises against antiseizure medicines or benzodiazepines solely for functional seizures when there is no other indication. If epilepsy or another indication exists, that requires its own treatment plan. Do not stop or reduce medication on your own.

Prepare for the review

Bring the actual medication list, including as-needed doses, supplements and who prescribed them. Note problems such as sleepiness, dizziness or confusion and ask which could be medication-related. Ask for a written plan that says what stays, what changes, who to contact and what to do if symptoms change.

During an event, use only the prescribed event-specific rescue plan. Do not add sedating medication to try to stop an unfamiliar event. During a change, a new event or substantial deterioration deserves prompt advice; do not assume it is ordinary FND.

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Help keep one current medication list if the person wants assistance. Do not hide medicines, skip doses, improvise a taper or pressure them to stop because an event was labelled functional.

Make sure emergency staff know about both functional seizures and any epilepsy. Bring the written plan, while allowing clinicians to assess a new or uncertain event.

For the Person With FND
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Explicit procedure

  1. Reconcile prescribed, over-the-counter and as-needed medicines, actual use and prescribers.
  2. Map every medication to a current indication and every rescue instruction to an event type.
  3. Revisit diagnostic uncertainty, including coexisting epilepsy, before withdrawing treatment.
  4. Explain expected benefits, adverse effects, interactions and the risks of abrupt change in accessible terms.
  5. When withdrawal is indicated, provide a drug-specific, individualized taper and monitoring plan; this reference supplies no dosing schedule.
  6. Coordinate with the other prescribers and document what to do during uncertainty or deterioration.
  7. Review tolerability and the original indication after the change, not only functional-seizure counts.

Pharmacology in plain language

Antiseizure medicines affect neuronal signalling—communication between nerve cells—but efficacy against epileptic seizures does not establish efficacy against functional events. Benzodiazepines can cause sedation and dependence; withdrawal risk is another reason for supervised changes. A temporary change in responsiveness after medication does not establish the event diagnosis.

Retain necessary treatment for other conditions. Escalating sedation for a known functional event and abruptly withdrawing necessary medication are both avoidable hazards.

Basis and evidence boundary

The AAN medication recommendations address functional seizures without epilepsy or another indication. The reconciliation steps are a practical clinical workflow, not a drug-specific prescribing protocol. [1]

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Research and Sources

Citation Full citation and source
[1] Tolchin B, Goldstein LH, Reuber M, Stone J, Perez DL, LaFrance WC Jr, et al. Management of Functional Seizures Practice Guideline Executive Summary: Report of the AAN Guidelines Subcommittee. Neurology. 2026;106(1):e214466. https://doi.org/10.1212/WNL.0000000000214466 FND-CIT-0010.

Created September 14, 2026 · Neurology, relevant therapy, lived-experience, caregiver and accessibility review pending

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
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