You cannot force a seizure to stop once it has started, but you can protect the person having one, and there are effective medications and strategies that prevent future seizures in the majority of people with epilepsy. What “stopping seizures” looks like depends on the timeframe: right now during an active seizure, in the minutes after one ends, or over the long term to keep them from happening again.
What to Do During an Active Seizure
Most seizures end on their own within one to three minutes. Your job during that window is to keep the person safe, not to stop the seizure itself. Move sharp objects and furniture out of the way. If the person is standing or sitting, gently guide them to the floor. Place something soft under their head. Turn them onto their side so saliva or vomit can drain instead of blocking their airway. Note the time the seizure started.
Do not hold the person down or try to restrain their movements. Do not put anything in their mouth. They cannot swallow their tongue, and forcing an object between their teeth can cause broken teeth or a bitten finger. Do not offer water or food until they are fully awake and alert. Stay with them after the seizure ends. They will likely be confused, sleepy, or disoriented for several minutes to an hour afterward.
When a Seizure Is a Medical Emergency
A seizure lasting five minutes or longer is classified as status epilepticus, a condition that can cause brain damage and requires emergency treatment. Call 911 if a seizure passes the five-minute mark. Also call if the person has a second seizure shortly after the first, has trouble breathing or doesn’t wake up afterward, is injured during the seizure, or if the seizure happens in water.
It’s also an emergency if the person has never had a seizure before, is pregnant, or has diabetes and loses consciousness. If you’re unsure whether someone has a seizure disorder, treat it as a first-time seizure and call for help.
Rescue Medications That Stop Prolonged Seizures
For people with known epilepsy who experience seizure clusters or prolonged episodes, doctors prescribe rescue medications designed to be given outside a hospital. These are fast-acting sedatives that a caregiver, family member, or the person themselves can administer when a seizure doesn’t stop on its own or when multiple seizures occur in a short period.
The most common options include a nasal spray form of midazolam, approved for people 12 and older, given as a single dose into one nostril that can be repeated after 10 minutes if needed. A nasal spray form of diazepam, approved for ages 6 and up, works similarly. There’s also a rectal gel form of diazepam that has been available longer and is widely used in children. Newer formulations include dissolving wafers placed between the cheek and gum.
These medications are meant for emergencies, not daily use. If your neurologist hasn’t discussed a rescue plan with you and you have recurring seizures, it’s worth asking. Having a rescue medication on hand, along with a written plan that people around you understand, can be the difference between a manageable episode and an ER visit.
Long-Term Medications to Prevent Seizures
Daily anti-seizure medications are the foundation of epilepsy treatment, and they work well for most people. An appropriately chosen medication provides adequate seizure control in 60 to 70% of patients. That leaves about 30% who continue to have seizures despite trying different drugs alone and in combination, a condition called drug-resistant epilepsy.
There are now more than 30 anti-seizure medications spanning three generations. Older drugs like valproate and carbamazepine have decades of use behind them and remain effective for many seizure types. Newer medications like lamotrigine, levetiracetam, and lacosamide often have fewer side effects and fewer interactions with other drugs. The newest generation includes cannabidiol (the CBD-based prescription medication), cenobamate, and others developed for specific hard-to-treat epilepsy types.
Finding the right medication often takes time. Your doctor will typically start with a single drug at a low dose and adjust upward. If the first medication doesn’t work or causes intolerable side effects, switching to or adding a second drug is standard. The process can take months, and it requires honest communication about side effects like drowsiness, mood changes, or cognitive fog, since those factors determine whether a medication is sustainable long-term.
Surgery for Drug-Resistant Epilepsy
When medications fail, surgery is the most effective option for people whose seizures originate from a specific, identifiable area of the brain. The results are striking: roughly two-thirds of people with temporal lobe epilepsy become seizure-free after surgery. In one randomized trial, 73% of surgically treated patients were seizure-free at two years, compared to none of the patients who continued with medication alone.
Success rates vary depending on the underlying cause. Seizures caused by brain tumors or vascular malformations have some of the highest cure rates after removal, reaching 70 to 91% seizure freedom in some cases. Seizures caused by structural brain abnormalities like focal cortical dysplasia have a 58% seizure-freedom rate. Even in severe cases requiring removal or disconnection of an entire brain hemisphere, 66 to 85% of patients achieve seizure freedom.
Surgery isn’t right for everyone. It requires extensive testing to pinpoint where seizures start and to confirm that removing that area won’t cause unacceptable deficits in language, memory, or movement. But for candidates who qualify, it remains underutilized. Many people with drug-resistant epilepsy wait years before being referred for a surgical evaluation.
Brain Stimulation Devices
For people who aren’t surgical candidates or who want a less invasive option, implanted neurostimulation devices offer another path. Two main types are used for epilepsy: responsive neurostimulation, which detects abnormal brain activity and delivers targeted electrical pulses to interrupt it, and deep brain stimulation, which sends continuous or scheduled pulses to deeper brain structures involved in seizure networks.
Neither device typically eliminates seizures entirely, but both reduce them significantly. In pooled analyses, responsive neurostimulation reduced seizure frequency by about 61%, and deep brain stimulation reduced it by about 56%. For many people with drug-resistant epilepsy, that reduction is enough to transform daily life, even if occasional seizures persist. A third option, vagus nerve stimulation, involves a device implanted in the chest that sends regular electrical signals to the brain through a nerve in the neck and has been used for epilepsy since the 1990s.
CBD for Specific Epilepsy Syndromes
Prescription cannabidiol is FDA-approved for two severe childhood epilepsy syndromes: Dravet syndrome and Lennox-Gastaut syndrome. In clinical trials for Dravet syndrome, about 43% of patients on CBD achieved a 50% or greater reduction in convulsive seizures. For Lennox-Gastaut syndrome, 39% of treated patients saw their drop seizures cut in half, compared to just 14% on placebo.
This is a pharmaceutical-grade, precisely dosed oral solution, not the same as CBD oil sold in stores. Over-the-counter CBD products are not regulated for consistency and have not been proven effective for seizure control. If you’re interested in CBD as a treatment, the conversation needs to happen with a neurologist who can prescribe and monitor the approved formulation.
Lifestyle Changes That Lower Seizure Risk
Seizures don’t happen randomly for most people with epilepsy. Specific triggers lower the threshold at which the brain produces a seizure, and managing those triggers is a meaningful part of treatment alongside medication.
Sleep deprivation is one of the most reliable seizure triggers. It increases the brain’s electrical excitability, and the effect is especially pronounced in temporal lobe epilepsy. This means consistent sleep schedules matter. Shift work, irregular bedtimes, and chronic sleep debt all destabilize seizure control by disrupting the brain’s normal rhythms.
Alcohol is another well-established trigger. Chronic use worsens seizure control, and withdrawal after heavy drinking is a known cause of seizures even in people without epilepsy. Alcohol also raises the risk of head injuries and blood sugar drops, both of which can independently provoke seizures. Stress plays a documented role too. People with well-controlled epilepsy consistently report lower perceived stress than those with uncontrolled seizures, and the relationship goes both directions: stress worsens seizures, and frequent seizures increase stress.
Nicotine may also be a factor. A review of 122 seizure reports among e-cigarette users found that 85% of seizures occurred within 24 hours of use, suggesting nicotine overdose can act as a trigger. The ketogenic diet, a high-fat, very-low-carbohydrate eating plan, has been used for decades to reduce seizures in children who don’t respond well to medication, though it requires medical supervision to avoid metabolic complications.
Keeping a seizure diary that tracks sleep, alcohol, stress, illness, and missed medications helps you and your neurologist identify your personal triggers and adjust your treatment plan based on patterns rather than guesswork.