Rescue Medications for Seizures
Most seizures stop on their own within a few minutes and do not require medication. For some people with epilepsy, however, a healthcare provider may prescribe a rescue medication for certain seizures or seizure patterns. Understanding when and how to use this medication can help caregivers and support persons respond safely and confidently.
Rescue medications are used when needed to help stop or shorten certain seizures. They may be prescribed for prolonged seizures, seizure clusters, or other seizure patterns that may require immediate intervention.
Rescue medications are different from daily anti-seizure medications. Daily medications are taken regularly to help prevent seizures, while rescue medications are used in specific situations according to an individual’s seizure rescue plan.
Key points: Rescue medication is not needed for every person with epilepsy. It is different from daily anti-seizure medication and is used only in the situations described in the individual’s seizure rescue plan. Basic seizure first aid still applies, and emergency medical assistance may still be required.
Who may need a rescue medication?
A healthcare provider may prescribe rescue medication for someone with a history of prolonged seizures, seizure clusters, or other seizure patterns that could require emergency treatment. The decision depends on the individual’s seizure history and treatment plan.
Types of rescue medications
Several medications may be used as rescue medications for seizures. Many belong to a group of medications called benzodiazepines.
Depending on the medication prescribed, rescue medications may be administered through different routes, including:
Buccally, into the space between the cheek and gum
Intranasally, through the nose
Orally, by mouth, when the prescribed medication and the person’s circumstances allow.
Rectally, such as a prescribed rectal gel
Examples of medications that may be prescribed as rescue medications include midazolam, diazepam, and lorazepam.
The medication, dose, route, and instructions for when it should be given will vary from person to person. Rescue medication should always be used according to the individual’s seizure rescue plan.
When is rescue medication used?
A person’s healthcare provider will determine when rescue medication should be given. This may include situations such as:
- A seizure that reaches the time limit specified in the person’s seizure rescue plan.
- Multiple seizures occurring close together
- Seizures occurring without the person fully recovering between them
- Another seizure pattern identified by the person’s healthcare provider
The person’s seizure rescue plan should clearly explain when rescue medication should be given and what steps to take if the seizure continues after treatment.
Do not guess when to give rescue medication or change the prescribed dose or instructions.
Always follow the healthcare provider’s directions and the person’s seizure rescue plan.
Rescue medication and seizure first aid
Rescue medication is part of a person’s overall seizure rescue plan. It does not replace basic seizure first aid.
A seizure rescue plan outlines when rescue medication should be given, the prescribed dose and how it should be administered, what to do if the seizure continues, and when to seek emergency medical assistance.
If someone is having a seizure:
- Stay calm and stay with the person.
- Move nearby objects that could cause injury.
- Protect the person’s head with something soft if they fall or are lying on a hard surface.
- Time the seizure and follow the person’s seizure rescue plan.
- Do not restrain the person.
- Do not put anything in the person’s mouth during a seizure, except when administering prescribed rescue medication according to the medication’s specific instructions.
- When the seizure subsides, gently turn the person onto their side if it is safe to do so.
If rescue medication has been prescribed and you have been trained to administer it, follow the instructions provided in the person’s seizure rescue plan.
Call 911 if:
- A convulsive seizure lasts longer than five minutes.
- Another seizure begins before the person has fully recovered from the previous seizure.
- The person does not regain consciousness or normal breathing after the seizure.
- The person is injured during the seizure.
- The seizure occurs in water.
- The person is pregnant or has diabetes.
- You do not know if the person has a history of epilepsy or seizures.
- The person’s seizure rescue plan directs you to seek emergency assistance.
Always follow the person’s seizure rescue plan, as it may contain specific instructions about when to administer rescue medication and when to call 911.
If you are supporting someone who has rescue medication
If you are a family member, caregiver, friend, school staff member, support worker, or someone else who may be expected to respond to a seizure, it is important to be familiar with the person’s seizure rescue plan.
This includes knowing:
- What the person’s typical seizures look like
- When rescue medication should be given
- Where the medication is kept
- What medication has been prescribed
- What your role is in administering it
- What to do if the seizure does not stop
- When emergency medical assistance should be called
Anyone who may be responsible for administering rescue medication should receive appropriate instruction and training on both the medication and the person’s seizure rescue plan.
Learning more about rescue medications
Understanding what rescue medications are, when they may be used, and how to follow a seizure rescue plan can help caregivers, family members, and other support persons feel more prepared to respond during a seizure emergency.
Epilepsy Ontario provides information, education, and support to people living with epilepsy, as well as their families, caregivers, and others who support them. We can help you learn more about rescue medications, seizure first aid, and supporting someone with epilepsy.
If you have questions about a specific rescue medication, including when it should be used, the prescribed dose, or how it should be administered, speak with the prescribing healthcare provider or pharmacist. Always follow the individual’s seizure rescue plan.
