Medically reviewed by Sarim Mir, MD, board-certified neurologist at Mir Neurology. Published July 2026.
A note on what’s real vs. what’s coming: This article separates treatments that are FDA-approved and available now from those still in development and not yet FDA-approved. Investigational treatments are not available to prescribe, and nothing here is medical advice. Talk with your neurologist about the options that apply to you.
For people whose seizures aren’t controlled by medication — known as drug-resistant epilepsy — the search for better options is deeply personal. The good news: the field is moving, with a newly expanded device therapy available now and promising medications in late-stage research. Here’s an honest look at what’s real progress and what’s still on the horizon.
What “drug-resistant epilepsy” means
Epilepsy is considered drug-resistant when seizures continue despite trying two appropriate anti-seizure medications at adequate doses. It affects a meaningful share of people with epilepsy — and it’s exactly the group that benefits most from staying current on new and expanded options. Learn about our epilepsy and seizure care.
Available now: expanded VNS device therapy
One concrete advance is already FDA-approved. Vagus nerve stimulation (VNS) therapy — a device that sends mild electrical pulses to help reduce seizures — has been approved for use in children as young as 4 years old with drug-resistant partial-onset seizures. Previously it was approved for patients over age 12, so this expands a proven option to younger children who haven’t responded to medication.
On the horizon: new medications in development
Several new anti-seizure medications are moving through late-stage clinical trials. One example is azetukalner, an investigational oral medication being studied as an add-on therapy for focal and generalized seizures. Early trial results have been encouraging, and it represents a potential new class of seizure medication.
Important: azetukalner and similar late-stage candidates are not yet FDA-approved and are not available to prescribe. They remain in clinical trials, and approval — if it comes — would follow after those studies are complete. We’re sharing this so patients know what’s being studied, not because it’s available today.
What drug-resistant patients can do now
While research advances, there’s a lot that current, approved care can do. That includes optimizing medication combinations, evaluating device options like VNS, considering whether someone is a candidate for epilepsy surgery evaluation, and confirming the seizure type with testing such as an EEG. Sometimes seizures labeled “drug-resistant” respond once the diagnosis or medication plan is refined.
Staying current matters
If your seizures aren’t well controlled, don’t assume you’ve run out of options. A neurologist can reassess your diagnosis, treatment plan, and candidacy for approved therapies — and keep you informed as new treatments become available. For ongoing epilepsy care, see our guide to living with epilepsy.
Talk with a neurologist
If drug-resistant epilepsy is affecting your life or your child’s, an evaluation can clarify your current options. To schedule in Hagerstown or Cumberland, book an appointment or call (301) 797-7600.
Sources: LivaNova. “FDA Approves VNS Therapy Treatment for Drug-Resistant Epilepsy in Children as Young as Four Years Old.” Xenon Pharmaceuticals clinical trial program for azetukalner (XEN1101), Phase 3 (investigational, not FDA-approved as of 2026). This article is educational and not medical advice; investigational treatments are not available to prescribe.
Frequently asked questions
Are there new epilepsy treatments in 2026?
Yes and pending. VNS device therapy is newly FDA-approved for children as young as 4 with drug-resistant seizures. Several new medications, such as azetukalner, are in late-stage trials but are not yet FDA-approved.
Is azetukalner available?
No. Azetukalner is investigational and not FDA-approved. It remains in clinical trials and cannot be prescribed at this time.
What is drug-resistant epilepsy?
It’s epilepsy where seizures continue despite trying two appropriate anti-seizure medications at adequate doses. It often benefits from specialist evaluation and additional options.
What can I do if my seizures aren’t controlled?
See a neurologist to reassess your diagnosis and treatment, consider approved device options like VNS, explore surgical candidacy, and confirm seizure type with testing like EEG.
Need to talk to a neurologist about this?
Mir Neurology offers same-week appointments in Hagerstown & Cumberland, MD. No referral needed for most plans.
