Treatment with Medication
Most children with epilepsy are treated with medication. Doctors will not usually prescribe medicine until after a child has had more than one seizure and been diagnosed with epilepsy.
When a child is taking medication for epilepsy, the goals are for the child to:
- Have no seizures, or as few as possible
- Have little or no problems with side effects
- Take one medication (monotherapy), or as few as possible
- Take the lowest dosage (amount) possible
Medication helps to control seizures for most children with epilepsy. If medication is not working, you may want to talk to your doctor about surgery, the ketogenic diet or vagus nerve stimulation (VNS). You should also consider getting another opinion from another doctor or at a special epilepsy center.
Finding the Right Medication
Children take the same antiepileptic drugs as adults. There are more than 20 medications available to prevent seizures in people with epilepsy. Most are taken orally (by mouth) and come in tablets, capsules, sprinkles or syrup.
In choosing which medication to prescribe for your child, your doctor will consider:
- What kinds of seizures your child is having
- Any other medications your child might be taking, as some medications shouldn't be taken together
- Side effects of different drugs (Common side effects include fatigue or tiredness, nausea, vision changes and weight gain)
Everyone reacts to medication differently. It can take awhile to find the right medication and the right dosage (amount) for your child. As your child grows or goes through puberty, the dosage may need to change.
If your child is on medication for epilepsy, it is important that you:
- Make sure your child is having regular check-ups at the doctor
- Know what side effects the medicine can cause and watch for them.
- Sometimes a child will have side effects when a new medication is started, but they will go away or become less of a problem as the child becomes accustomed to the medication
- Other times, side effects start over time because too much of the medication builds up in the child's blood
- Talk to doctors about other options if your child continues to have seizures or trouble with side effects
For some children, generic drugs offer a lower cost alternative to brand name medications. Although they are almost exactly the same, some minor differences or variations are allowed. Thus, you should always ask your doctor before switching to a generic medication and bring your child in for check-ups afterward.
Helping the Medication Work
Most children are able to control their seizures with medication. In fact, medication often works so well that parents are tempted to take their child off the medication or reduce the dosage. Doing so without a doctor's recommendation is dangerous and could cause a serious increase in seizures. In most cases, children need to stay on their medication for a few years before trying to stop. Always talk to your doctor before making any changes in your child's medication.
Although many parents worry that being on an antiepileptic medication for a long time could lead to drug abuse, it is rarely the case. The opposite is actually more common, with teenagers sometimes rebelling against taking their medicine.
Even the most dedicated parents and children sometimes have trouble being compliant with their medication, which means following their doctors' directions on when and how much medicine to take. While some studies show that 73 percent of people with epilepsy are compliant, others report that 50 percent sometimes forget to take their medication.
Being compliant is particularly important for children with epilepsy. Missed or incorrect dosages of medicine greatly increase a child's chances of having a seizure. As children grow, they should begin to take some responsibility for remembering to take their medication. If your child needs to take medicine at school, you'll usually need to make arrangements with the teacher or school nurse.
Following are some tips that can help you make sure that your child gets the right amount of medicine at the right time:
- Keep medicine in a convenient spot where it becomes part of other daily activities; for example, near your child's toothbrush, in the kitchen, etc.
- Use a watch with a beeper to remind you or your child when it's time to take the medicine.
- Get a pillbox and count out the right amount of pills for each day, then track whether they're taken.
- If your child is older and not always with you or another adult when taking medicine, you might want to check to make sure it's being taken correctly. You can do this by having your doctor check the level of medicine in your child's blood at appointments.
- Make sure to refill prescriptions in enough time so that you don't run out of medicine.
- Ask your doctor what to do if your child:
- Misses a dose of medicine
- Throws up just after taking medicine
- Needs to take another medication, to make sure it can be taken with the epilepsy medication
By working with your doctor, you can help make sure that your child is always getting the full benefits of treatment.
While it's extremely important that children with epilepsy stay on their medication for as long as their doctors recommend, after a few years of being seizure free most children are able to stop taking it. Medicine should always be stopped slowly, under careful supervision from a doctor. Stopping medication all at once can lead to seizures and even prolonged seizures or status epilepticus.
Studies show that 65 percent to 70 percent of children who have been on medication for a few years and not had any seizures can stop taking it gradually without seizures recurring (starting again). However, this varies greatly by the individual child and types of seizures the child had.