For Parents

Treatment with Medicines

Childhood epilepsy is usually treated with seizure-preventing medicines called antiepileptic or anticonvulsant drugs.

If the drugs don’t work or if the child has a lot of side effects, surgery, the ketogenic diet, or vagus nerve stimulation (VNS) may be tried.

Medication

Children take the same antiepileptic meds as adults do. Medication may be prescribed as tablets, sprinkles, capsules or in syrup.

These drugs are designed to prevent seizures. Some are successful with a limited number of seizure types; others have a broader range of action. Whenever possible, doctors try to control seizures with one drug. Some children, however, may have to take more than one.

Children may respond so well to medication that no further seizures occur so long as the medication is taken regularly and an effective level is maintained in the child’s blood.

Not having seizures does not mean that the medication is no longer needed. Most children require a minimum of several years of therapy. Always ask the doctor before stopping antiepileptic medication.

Giving a child only part of the medication, or stopping it abruptly can cause a serious increase in seizure activity.

Finding the right drug

The search for the best medication for any individual child may take quite a long time.

Children, like adults, respond to medications in different ways. Several drugs or different combinations of drugs may have to be tried in an effort to get the seizures under control.

The goal of treatment is to achieve the greatest level of control, the lowest level of side effects, at the lowest possible dose.

Common side effects from antiepileptic drugs include fatigue, nausea, changes in vision, and weight gain.

Some side effects are linked to high dosages. Others are due to individual sensitivity or allergic reaction. Some tend to happen when a new medication is started, but go away (or become less of a problem) as the child becomes accustomed to it.

Helping the Treatment Work

  • Ask your doctor about possible side effects associated with the medicine and what you should do if you see them.
  • Keep follow-up appointments. Some medications require periodic blood tests that are important to your child's health. Ask the doctor at the end of each visit when he or she wants to see you both again, and make the next appointment then.
  • Don't change the dose or discontinue seizure medicine on your own without checking with your child's doctor.
  • Ask for refills from your pharmacy several days before the medication is due to run out.
  • Ask your doctor whether any over-the counter medicines may interfere with the epilepsy drug your child is taking. Check with the pharmacist when buying other medicines.
  • Ask your doctor how to handle fever associated with childhood illness. Ask, too, about the best way to give medication when a child has a stomach virus and cannot keep medication down.
  • Find out what you should do if your child misses a dose of medication.

Parents often worry that long term use of antiepileptic drugs may lead to drug abuse or dependency in their children.

Most doctors say there is very little if any abuse of these medications among young people with epilepsy. In fact, refusing to take the medication is a more common form of rebellion among teenagers.

Taking responsibility

When children are small, the parents are the ones who make sure the meds are taken on time. As children get older, they may take on more of this responsibility themselves.

Even with the best of intentions, however, children may forget. One way of monitoring whether the medication is being taken is to count out (or teach the child to count out) each day's doses and store them in a special container so you can track whether or not the tablets or capsules have been taken.

If a school-aged child has to take medication during the day, check with the school about what arrangements should be made. Most school systems will not allow children to give themselves medication at school, but will arrange for the school nurse or other school official to do so.