Anti-epileptic medications (AED) are given generally as the first treatment option for people diagnosed with epilepsy. They are preventative medications designed to calm the over-excited brain cells that cause seizures. Neurologists aim to stop seizures by choosing the best AED for a person based on age, seizure type, sex, side effects and optimum control. Their preference is always going to be monotherapy but, quite often, two or more AEDs are used to gain best seizure control.
Anti-convulsant medications generally have half-lives of less than 24 hours. Therefore, it is important that medications are routinely taken 12 hours apart, for example, 7 am and again at 7 pm every day. A half-life is the time it takes for half of the dose of your medication to be eliminated from your bloodstream. Regular dosing maintains therapeutic levels and hopefully maximises good seizure control.
Are you having problems taking your medications?
1. You don’t want to take them?
Please understand what epilepsy is and why medications are given. You may need to seek further advice from your neurologist, GP, pharmacist or epilepsy adviser for an explanation. No question is a silly question. Epilepsy is just another medical condition that can normally be treated, as occurs with asthma and diabetes for example.
2. You don’t like the side effects of medications?
If you are worried about the side effects of your medication, you are less likely to take them. It is important to take note of all side effects and to have a discussion with your neurologist, GP, pharmacist or epilepsy adviser. It may be that the dose of your medication is too high, or that the medication doesn’t suit you. Many side effects disappear over a little while but always express your concerns so that you receive the best seizure treatment plan for you.
3. You forget to take your medications?
You are not alone here. At least 30% of people with epilepsy can forget taking their medications because of poor memory caused by seizures, the medications themselves, because of another disability such as having had a stroke. Missing the odd dose of medications is normal but it is best to get into good habits, if you can.
If you forget to take your medication, take it as soon as you remember unless it is near to your next dose.
Do not double the dose to make up for the one that you forgot to take.
4. You need some useful tips to help you remember when to take your medications?
- Get into a routine – such as taking medications at meal times.
- Use an alarm, medication diary, smart phone application, chart, calendar, post-it notes etc to remind you when to take your medications.
- Use a pill box to repackage your medications, or use a blister pack or sachet rolls. Your pharmacist will provide these for you. Better packaging may help you with what to take and when.
5. You don’t believe that you have epilepsy anymore?
Please do not stop taking medications to see if you still have epilepsy. All medication changes are to be made by the neurologist and this is to prevent any injury or death to you around seizures. Status epilepticus is a seizure that doesn’t stop, and it is deemed to be a medical emergency, and SUDEP (Sudden Unexpected Death by Epilepsy) can be avoided in many cases, simply by taking medications correctly. It may be that you don’t have epilepsy anymore but please allow the neurologist to make that assessment of you.
6. You have difficulties swallowing your medications?
This is especially true for children who may have problems swallowing tablets, or for people who have had a stroke or head injury. Being unable to swallow is called dysphagia and it can occur at any age, but it is common in older adults. If taking tablets is difficult then some formulations of medications can be crushed or compounded into a suspension. Some medications may come in capsule form and be sprinkled onto food for easier administration. A chat with your local pharmacist could possibly help here.
7. It costs too much?
Each prescription is currently charged at $5. You become eligible for a pharmacy subsidy once you have paid for 20 new prescription medicine items from the 1st of February of each year. Ask your pharmacy if you qualify for the subsidy. If you are receiving the Disability Allowance your medications are paid for through Work and Income.
8. You find the list of your medications confusing?
You may find that you are taking more than just anti-epileptic medications as part of your daily medication routine. To better understand if these medications are working well for you, you can enlist the support of your local pharmacist or the Medicine Management service. They will discuss with you:
- Medicines and why we take them
- How medicines work in your body
- How to take medicines correctly and at the best times
- How to get the most out of your medicines
9. You can’t travel to the pharmacy to get your medications?
Transport can be a major problem for some people with epilepsy and this can prevent them accessing essential services, such as going to a pharmacy to pick up medications. Help may be given through for the Community Pharmacy Long Term Conditions Service. Please ask your pharmacist if you are eligible for this service.
10. You can’t follow the instructions on how to take your medications?
Ask your doctor to clearly explain how to take your medications, especially if there is to be a medication change. Write it down. Make sure that the pharmacist also clearly writes this information down on your medication package so that everyone knows the routine that you are to follow.
Please learn to take responsibility for your seizure control by correctly managing your medications.
Disclaimer: this fact sheet is for education purposes only. Please consult your doctor or other health professional for advice regarding your epilepsy.