Understanding Your Treatment
Medications
Anti-seizure medications are a main treatment for epilepsy. Finding the right treatment means balancing seizure control, side effects and your individual health needs.
About this information: This webpage is subject to continuous review by Epilepsy Ontario to help keep the information current. Updates to linked pages may be in progress. This material is for informational purposes only and should not be used for self-diagnosis or as a substitute for professional medical advice, diagnosis or treatment.
Do not start, stop or change prescribed medication without guidance from your healthcare provider. Your pharmacist and prescriber can explain instructions specific to your medicine.
How Treatment is Chosen
Drug Therapy
Medicines may be prescribed alone or in combination. The choice depends on factors including seizure type, epilepsy syndrome, other conditions, possible interactions and personal circumstances.
You may hear the terms “anti-seizure medication,” “antiseizure medication,” “ASM,” “antiepileptic drug” or “AED.” Older pages and records may use different terms for the same group of medicines.
When to start medication
The decision follows assessment of the diagnosis, the risk of further seizures and the benefits and risks of treatment. In some circumstances, medication may be considered after a first seizure.
Ask your clinician why a particular treatment is being recommended and what to expect.
Dosage
The dose and any gradual changes must follow your prescription. Your healthcare team considers effectiveness, tolerability and other relevant factors.
Do not use another person’s dose or a general webpage as instructions for your own medicine.
Everyday Medication Safety
Taking Medication Safely
Follow your schedule.
Take medication as prescribed. Ask about reminders, refill planning or pharmacy packaging if keeping track is difficult.
If you miss a dose, vomit after taking it or accidentally take too much, get medicine-specific advice promptly from your pharmacist or prescriber. Do not double a dose unless specifically instructed.
Check before changing the form.
Do not crush tablets, open capsules or mix medication into food without checking with your pharmacist. Some formulations must remain intact.
If swallowing or giving medication is difficult, ask about suitable formulations and a practical plan, including for children.
Check interactions.
Tell your healthcare team about all prescriptions, non-prescription medicines, supplements and herbal products.
Ask before adding a new product. Some interactions can affect seizure control, side effects or the effectiveness of other medicines.
Plan for supply problems.
Contact your pharmacist early if you are running low or your usual medicine is unavailable. Do not ration doses or make your own substitutions.
Monitoring Your Experience
Side Effects
Side effects vary by medicine and person. They may include tiredness, dizziness, nausea or changes in thinking, mood or behaviour. Ask which effects to watch for with your particular prescription.
Report problems.
Tell your prescriber about effects that interfere with daily life, new symptoms or changes after a dose adjustment. Record when symptoms occur and how they affect you.
Ask what needs urgent attention and whom to contact outside office hours.
Recognize serious reactions.
Call 911 for trouble breathing, swelling of the tongue or throat, collapse or another medical emergency.
A new rash needs prompt medical advice. A painful, blistering or peeling rash, or a rash with mouth sores or fever, needs urgent medical assessment. Do not wait for a routine appointment.
Blood Level Monitoring & Follow-Up
Monitoring is tailored to the medicine and situation. Blood levels may be useful for questions about seizure control, side effects, interactions, pregnancy or other clinical circumstances; not everyone requires routine drug-level testing.
Results must be interpreted alongside your symptoms and treatment history. Do not adjust a dose yourself based on a laboratory number.
Effectiveness of Medication
The aim is the best possible seizure control with acceptable side effects. Keep a record of seizures and concerns so you can review progress with your healthcare team.
If seizures continue despite adequate trials of two appropriately chosen, tolerated and used medication schedules, ask about specialist assessment and additional treatment options.
Changing or Stopping Medication
Being seizure-free does not automatically mean medication can be stopped. Your clinician needs to assess the benefits, risks and your circumstances.
If a change is appropriate, follow an individualized plan. There is no single withdrawal schedule suitable for everyone. Stopping suddenly can cause serious problems, including prolonged seizures.
Explore Further
Medication Topics
These existing pages remain available while the section is being updated. Confirm current medicine instructions and safety information with your pharmacist or prescriber.
Medication Information
Pregnancy planning or a new pregnancy?
Contact your epilepsy healthcare team promptly for a medication review. Discuss contraception, pregnancy planning and monitoring. Do not stop your medication on your own if you become pregnant.
Prescribed Treatment for Specific Situations
Rescue Medications
Rescue medications are different from daily anti-seizure medications. They are used in specific situations according to an individual’s seizure rescue plan.
Medication Education Video
This existing video is retained as an educational resource. Confirm current, medicine-specific advice with your healthcare team.
Further reading:
ILAE: Medical Therapies.
