Treatment & Growing Up
Children and Anti-Seizure Medications
Treatment should reflect the child’s seizures, health and everyday needs. The goal is the best possible seizure control with side effects that are manageable.
About this information
Epilepsy Ontario reviews this educational content regularly. It does not replace professional medical advice, diagnosis or treatment. Your child’s prescriber and pharmacist should provide instructions for their particular medicine.
Do not start, stop or change prescribed medication independently.
When is medication considered?
There is no rule that every child must have two seizures before treatment can begin. A clinician considers the diagnosis, the likelihood of further seizures, investigation results and the benefits and risks of treatment.
Medication may be recommended after a first unprovoked seizure in some circumstances. In others, further assessment or observation may be appropriate. Ask the clinician to explain the recommendation for your child.
An Individual Plan
Finding a suitable medicine and dose.
Choosing treatment
The seizure type, epilepsy syndrome, age, other health conditions and possible interactions help guide the choice. Children with similar seizures may need different treatments.
Adjusting the dose
Age, weight, seizure control and tolerability can affect dosing. Some medicines are introduced gradually. Follow the prescribed schedule rather than adjusting the amount yourself.
Daily Routines
Make medication instructions clear.
- Keep an up-to-date list of medicines and dosing instructions.
- Agree who will give each dose and record it when needed.
- Ask the pharmacist about missed doses, vomiting or an accidental extra dose.
- Check before adding non-prescription medicines or supplements.
- Arrange refills before the supply runs out.
- Ask before crushing tablets, opening capsules or changing formulations.
School and other caregivers
If medicine is needed during school or childcare hours, agree on a written administration plan. Share updated instructions with the people responsible for giving it.
Keep the child’s seizure action plan current, including any separately prescribed rescue medication instructions.
How Your Child Feels
Notice changes and report concerns.
Possible side effects
Depending on the medicine, changes can include sleepiness, dizziness, stomach upset, irritability or difficulties with attention and memory.
Tell the healthcare team about symptoms affecting learning, activities or family life.
Urgent symptoms
Call 911 for breathing difficulty, swelling affecting the airway, collapse or another medical emergency.
A new rash needs prompt medical advice. Blistering or peeling skin, mouth sores or a rash with fever requires urgent assessment.
Ongoing Care
Review treatment as your child grows.
Keep a record of seizures and possible side effects. Ask how often follow-up is needed and whether any blood tests or other monitoring are appropriate.
Growth may change treatment needs, but a dose increase is not automatic. The healthcare team should assess the whole picture.
Being seizure-free does not automatically mean medication can be stopped. Any withdrawal decision requires an individual review and a supervised plan. Sudden stopping can cause serious seizures.
Questions to bring to an appointment
- Why is this medicine recommended?
- How will we know whether it is helping?
- Which side effects need urgent attention?
- What should we do if a dose is missed?
- Who should we contact if seizures or side effects change?
Further reading:
SickKids: medications for epilepsy
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Managing and monitoring medication
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NICE: treatment and monitoring guidance.
