What pharmacotherapeutic strategy do you use in catamenial epilepsy to further reduce risk of breakthrough seizures around the time of menses?

Evidence is conflicting and incomplete, but suggests that benzodiazepines may be beneficial. I often prescribe clobazam in the week of menses in those patients who do not want to take the medication continuously all month long.

The use of acetazolamide may be beneficial as well in some patients. Alt...

Midazolam or Diazepam Nasal spray PRN can also work. PRN warning of seizure or not feeling right if they can.