A new study from the UK says that it is not neccessary to rush to put people on drugs if they have only infrequent seizures.
They say that delaying medication does not increase the risk of chronic epilepsy or have a negative impact on quality of life.
The Liverpool University researchers say that waiting until treatment is absolutely necessary also avoids unnecessary drug side effects.
Professor David Chadwick and colleagues recruited for their study about 1,400 people with single or infrequent seizures. Half of the group were given antiepileptic drugs carbamazepine or valproate immediately, while the other half did not receive any treatment until they and their clinician agreed it was necessary.
The researchers then monitored what happened to the patients for the next five years.
They found that immediate drug treatment though it reduced the likelihood of a repeat seizure in the short term, over the course of the study both interventions resulted in similar rates of seizure recurrence.
There also appeared to be no difference in the quality of life experienced between the two groups and delaying treatment led to fewer reports of side effects.
The study results suggest there is little to gain in the long-term from starting medication immediately.
Professor Chadwick said in conclusion, that after two years, the benefits of improved seizure control with immediate treatment seem to be balanced by the unwanted side effects of drug treatment and there is no improvement in measures of quality of life.
Samuel Berkovic from the Epilepsy Research Centre at Melbourne University, Australia, says the results of the study do suggest little is gained in the long-term from starting medication immediately.
Professor Ley Sander of the National Society for Epilepsy found the study most interesting and said it confirmed the current practice of deferring treatment for most people presenting with a first unprovoked epileptic seizure, and provided solid evidence for the practice.
Epilepsy Action said timing the start of treatment often depended on the clinician involved and the patient's individual circumstances.
The study is published in the Lancet.