Accumulating data that link the gut microbiome to epilepsy and seizures have raised questions about the therapeutic potential of microbiome modulators in this setting. Numerous studies have shown the gut microbiota composition can influence seizure frequency and response to epilepsy therapy. Stefanie Prast-Nielsen, PhD, Karolinska Institutet, Solna, Sweden, discusses several strategies that are under investigation as possible future anti-seizure therapies. Both probiotics and antibiotics are being studied for their capacity to modulate the gut microbiome composition in a way that improves seizures or treatment responses. However, it is important to narrow in on the specific mechanisms at play in order to target the right species of bacteria that will result in a beneficial response. For this reason, phage therapy is also a possibility, as it can target specific microbiome components more specifically than broad-spectrum antibiotics. This interview took place at the 14th European Epilepsy Congress (EEC) 2022 in Geneva, Switzerland.