The primary treatment for seizures is antiepileptic medicine. Seizure medications do not cure seizures, they control seizures. Unlike antibiotics, you cannot take seizure medicines for 10 days and be cured.
Your child needs to take the medicine on a regular basis every day to keep an even level of medication in their body. Most medications are taken two (2) times each day but some may be taken only once a day and some may need to be taken three (3) or four (4) times a day. The type of medicine used for your child will depend on the type of seizures, your child’s age and health, and possible side effects of the medications. For example, one medicine can cause an increase in hunger and weight gain so if possible we avoid using this medication in children who are already overweight.
There are many medications available to help children with epilepsy. Medications used most often include:
The amount of medication prescribed is based first on your child’s weight but then may be adjusted up or down based upon seizure control and/or side effects. Our goal is to prevent all seizures without causing any intolerable side effects.
All medications (even over the counter medicines such as acetaminophen) have the risk of side effects. All seizures medications have some risk of side effects. Most side effects are not serious but occasionally they can be more severe.
The most common side effect of seizure medications is feeling sleepy. When first starting a medication or when the dose is increased some children may feel a little drowsy for the first few days. Most children adjust to the medication and are back to feeling normal within a week. We often start with a very low dose of medicine and slowly increase the dose to help control the sleepy feeling. Sometimes we have to increase the dose more quickly if a child is having frequent seizures and sleepiness may be more of a problem for the child.
Other side effects may include dizziness, upset stomach, and skin rash. A few medications can affect appetite. All seizure medications carry some risk of change in mood and behavior, including a very small risk of thoughts of suicide. Your doctor or nurse practitioner will always discuss side effects of your child’s medication with you.
Most children can use the generic form of seizure medications. Sometimes a child will be sensitive to even slight changes in their medication. These children may need to use the brand name medication. When starting a medication it is usually okay to start with the generic. If problems arise the healthcare team can change the prescription to the brand name.
Your child’s response to seizure medications may change when other medications are started. This could increase your child’s risk of having seizures or increase the risk of side effects from the medications.
If your child has a runny nose, cough or other cold symptoms, avoid use of over the counter medications if possible. Acetaminophen and ibuprofen are generally safe to use for treating pain and fever. Medications containing pseudoephedrine should be avoided as they may increase the risk of seizures but if necessary they can be used sparingly.
Some birth control medications may interact with seizure medications and cause either the birth control or the seizure medicine to be less effective. Talk with your doctor or nurse practitioner before starting any form of birth control.
To minimize the risk of drug interactions, keep a list of all medications your child is taking, including the dose, to share with your doctor or nurse practitioner at each appointment. It is important to talk to your doctor, nurse practitioner or pharmacist before giving your child any other medications. This includes prescription medications, over-the-counter medications, vitamins and herbal supplements.
If your child vomits within 15 minutes of taking his medicine, you can repeat the
dose one time.
If he vomits again, do not give him any more medication. Wait until the next scheduled dose and try again.
If he vomits and it has been at least 15 minutes since he took his medicine, do not give any more medication. The medicine has already been absorbed into his body.
It is important to take all seizure medications on a regular basis as prescribed by your child’s doctor or nurse practitioner.
When we first start a medication your child receieves the lowest dose we think will work. This may not be the right dose and we may need to increase the dose several times to get to the right level of medication for your child. We can often increase a dose of medication three or four (3 or 4) times the starting dose before it is too much medicine for your child. If we reach the maximum dose for the medication and your child is still having seizures we may need to try a different medication or add another medication. Unfortunately, there is no magic bullet for seizures. The first seizure medication chosen has about 60% chance of controlling seizures. If that medication fails, the chance of seizure control drops to 10%. If two medications fail, then there’s only a 1-2% chance of controlling seizures. Therefore, if two (2) medications have not worked for your child we may consider other treatments. These therapies are described briefly below. Your neurology provider can give you more information if these therapies are appropriate for your child: