Treatment in Later Life
Older Adults and Medications
Epilepsy treatment should support seizure control, independence and quality of life. Choosing medication involves considering your other treatments, health conditions and everyday needs.
About this information
Epilepsy Ontario regularly reviews this educational material. It does not replace professional medical advice, diagnosis or treatment. Ask your prescriber or pharmacist for instructions specific to your medicines.
Do not start, stop or change prescribed medication independently.
An Individual Approach
Find the right balance for you.
Choosing medication
Your healthcare team considers the seizure type, other health conditions and possible interactions. Your priorities and experience of treatment also matter.
Starting and adjusting treatment
Older adults may benefit from a lower starting dose and slower increases. The schedule must be tailored to the person and medicine.
Kidney function
Kidney function can affect how some medicines are cleared from the body. Changes may require monitoring or a prescribing adjustment.
Follow-up
Ask when treatment should be reviewed and which tests are needed. Report new symptoms, seizures or difficulties managing the prescription.
Medication Safety
Check the whole medication list.
Interactions can change the effects of seizure medicines or other treatments. Keep your prescriber and pharmacist informed about everything you take, including non-prescription products, vitamins and herbal supplements.
Ask for an interaction check whenever a medicine is added, stopped or changed. Do not assume an over-the-counter product is suitable because it is available without a prescription.
Your Everyday Experience
Report effects on comfort and independence.
Balance and alertness
Dizziness, sleepiness, blurred vision or unsteadiness can increase injury risk. Tell your healthcare team about falls or near-falls, particularly after a treatment change.
Thinking and mood
Some medicines can affect concentration, memory, energy or mood. Describe when changes began and how they affect daily activities.
Ask about bone health.
Some anti-seizure medicines are associated with bone loss. Discuss your overall fracture risk and whether bone-density testing, dietary changes or supplements are appropriate.
Supplement needs differ. Ask before starting calcium, vitamin D or other products.
Make the routine manageable.
- Keep one current medication list for appointments and pharmacy visits.
- Ask about reminders or pharmacy packaging if doses are difficult to track.
- Request medicine-specific instructions for missed doses.
- Arrange refills early.
- Ask before crushing tablets or changing formulations.
- Include a trusted support person if you would find that helpful.
Reviewing Your Care
Bring your questions and observations.
- Are my seizures adequately controlled?
- Could medication be contributing to symptoms I have noticed?
- Have my other treatments or health conditions changed?
- Do I need blood tests or other monitoring?
- Could the dosing routine be easier to manage?
- Who should I contact between appointments?
Bring a seizure record and your current medication list. Any change or withdrawal should follow an individual plan agreed with your prescriber.
Know when to seek help.
Call 911 for breathing difficulty, swelling affecting the airway, collapse or another medical emergency.
A new rash needs prompt medical advice. A blistering or peeling rash, mouth sores or a rash accompanied by fever requires urgent assessment.
For seizure emergencies, follow your seizure action plan and the full first aid guidance.
Further reading:
NICE: treatment and monitoring
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Epilepsy Foundation: medicine interactions
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Medicine side effects.
