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Taking epilepsy medicine

This information is relevant to people who live in the UK.

Epilepsy is usually treated with epilepsy medicines. They don’t cure the epilepsy, but try and stop the seizures happening. They do this by changing the levels of chemicals in the brain that control electrical activity.

Starting treatment

A single seizure is not always classed as epilepsy, so wouldn’t always need treating with epilepsy medicines. However, if you're considered to be at a high risk for further seizures, your specialist might suggest prescribing epilepsy medicines after a single seizure.

There are many different epilepsy medicines available. When the specialist is deciding which one will best suit you, they will consider things like:

  • The types of seizure you have, as some medicines are only effective for certain types of seizure
  • Your age and sex
  • Your lifestyle
  • Any other medical conditions you have
  • Any other medicines you take
  • Which medicine you would prefer

Doctors usually try to prescribe just one epilepsy medicine at a time. This is because the more you take, the higher the risk of having side-effects. For 5 out of 10 people with epilepsy, the first epilepsy medicine they try will stop their seizures. But some people need to take 2 or more different epilepsy medicines. These are usually medicines that work in different ways, but work well together. And some people continue having seizures, even though they have tried a number of different epilepsy medicines, in different combinations.

How long will it take for my medicine to work?

Many people with newly-diagnosed epilepsy respond well to epilepsy medicine and have fewer seizures. It’s not possible to say how long this will take. But for many people, it happens quickly. For others, it takes longer.

About 3 in 10 people with epilepsy have seizures that don’t respond well to epilepsy medicine. They continue to have seizures even though they have tried 2 or more different medicines.

Taking epilepsy medicine

Epilepsy medicine is usually available as tablets, capsules, liquids and chewable or crushable tablets. If you find tablets difficult, ask your GP to prescribe you something easier to swallow.

Epilepsy medicine is usually taken once or twice each day. Sometimes it is taken 3 times a day. It’s important to take it regularly, as prescribed by your doctor, because missing a dose can increase the risk of having a seizure.

Once you are prescribed epilepsy medicine, it’s a good idea to get advice about what to do if you ever forget to take it. You could speak to your epilepsy specialist, GP or epilepsy nurse about this. They can also tell you what to do if you have sickness or diarrhoea. The advice they give you will depend on which epilepsy medicine you are taking, and the dose.

What are the usual doses of epilepsy medicine?

Your doctor will tell you how much of your epilepsy medicine you should take, and what time of day you need to take it. It’s usual to start on a low dose and gradually increase it to the maintenance dose. This is the amount that is thought to work well at controlling seizures.

Each epilepsy medicine has a different maintenance dose. For example, for carbamazepine it is between 800 and 1,200 milligrams (mgs) each day. For zonisamide it is between 300 and 500 mgs each day.

It can take a few weeks or months to reach the maintenance dose. Starting at a lower dose, then gradually increasing it, allows your body to slowly get used to the medicine. This reduces your risk of side-effects.

Sometimes, your doctor might advise you to take a higher or lower dose than the recommended maintenance dose. This could be to get better seizure control or to reduce your risk of side-effects.

Making treatment with epilepsy medicine easier

Here are some suggestions:

  • Ask the pharmacist for clear instructions on how to take it
  • If you find the packet leaflet difficult to read because the type is too small, ask for one in large print
  • If the packaging is difficult for you to open or handle, ask the pharmacist to change it
  • Ask the pharmacist if they sell dosette boxes or something similar. These keep your medicines organised and may help you to take the right ones at the right time
  • Contact the Disabled Living Foundation for information about other special pill containers or alarms that you can buy. These can be used to remind you to take your medicine
  • Once your dose is stabilised, ask your GP if they would be prepared to give you prescriptions for enough medicine to last 2 or 3 months
  • Sign-up for your GP’s online service. This allows you to order your repeat prescriptions online. If you wish, you can also give access to someone else, such as a partner or carer, so they can order prescriptions for you
  • If your GP and pharmacist use the Electronic Prescription Service (EPS), they may be able to arrange for your prescriptions to go directly to your pharmacist. This means you no longer have to remember to order your prescriptions. The pharmacist will automatically do that for you. And some pharmacists offer a delivery service too. See the NHS website to search for pharmacists near you.

Do I need regular blood tests?

You will only usually need to have blood tests to monitor your epilepsy medicine if, for example:

  • Your doctor wants to make sure you are taking the right dose of your epilepsy medicine
  • You are having side-effects from your epilepsy medicine that could be related to too high a dose
  • You are pregnant, or have recently given birth, and there is concern that your medicine level may be too low, or too high
  • You are going to start, or stop taking another epilepsy medicine that could interact with your epilepsy medicine
  • You are taking a medicine for another condition that could interact with your epilepsy medicine

You may also be offered blood tests to check your general health. 

Getting the same version of your epilepsy medicine every time

Epilepsy Action believes that it is important that you get the same version of your epilepsy medicine, every time you pick up a prescription. To find out more visit our page on getting the same version of your epilepsy medicine every time.

If you would like to see this information with references, visit the Advice and Information references section of our website. If you are unable to access the internet, please contact our Epilepsy Action Helpline freephone on 0808 800 5050.

Code: 
B004.05

Epilepsy Action would like to thank thank Dr John Paul Leach, consultant neurologist, Southern General Hospital, Glasgow for his contribution.

Dr John Paul Leach has declared no conflict of interest.

This information has been produced under the terms of The Information Standard.

  • Updated May 2017
    To be reviewed May 2020

Comments: read the 10 comments or add yours

Comments

My daughter is on keppra and lamactal which she takes 2 times a day morning and night she forgot to take her keppra yesterday morning could she have a seizure

Submitted by Jessica on

Hi Jessica

If your daughter hasn’t had a seizure by now she will probably be okay.

There are a wide variety of ways for helping yourself remember to take your tablets. Have a look at our wellbeing page on taking epilepsy medicine for some general guidance. Or put ‘pill reminders’ in your search engine.

Regards

Cherry  

Epilepsy Action Helpline Team

Submitted by Cherry-Epilepsy... on

I take 750 kappra twice a day for epilepsy I always feel sick but not because of the tablets , I have domperidone tablets to take but worry they will prevent my epilepsy tablets from working Regards Jo

Submitted by Jo reeder on

Hi
I’ve suffered with epilepsy for 40 yrs, varying types of seizures depending on the medications. Currently I’ve been on Keppra for 1 month (full dose) 500mg taken twice a day, plus Zonisamide 250mg twice a day & Clobazam 15mg daily.
Having changed from lamotrigine to Keppra I feel flat & empty, should this pass? I’m lucky that my seizures are now mild & infrequent.

Submitted by Sarah on

Hi Sarah

If the feeling you are describing is a side-effect of your Keppra, it may lessen over time, as your body gets used to this medicine.

If this feeling continues, it may be best to talk to your epilepsy specialist or epilepsy nurse. They might make changes to your epilepsy medicine to reduce the side-effect.

If we can be of any more help, please feel free to contact our helpline team directly. You can either email helpline@epilepsy.org.uk or phone the Epilepsy Action Helpline freephone 0808 800 5050. Our helpline is open Monday to Friday, 8.30am until 5.30pm.

Regards

Diane

Epilepsy Action Helpline Team

Submitted by rich on

Keppra stop my seizures I felt so low and down but thought may be realisation of not being able to nurse sinking in.
Taking Vit B and B12 supplement has massively helped my mood and lessened the SE’s altho that may be as I also thought so what if I can’t drive / work a seizure can kill. I’m a happy commuter and working 3 days a week as a nurse :-) seizure free 15m & younlearn who your mates are & if like me have the most eclectic music on my iPod (memeory loss - yep cluster of 5 seizures in 6 days & Keppra uses know so I’m kinda rediscovering old loves).
There is life again I was so low but epilepsy action were amazing after it was implied I could be saying having seizures and claiming benefits as no eveidence (A&E resus witnessed.....photo’s shown to neuro discharged with Keppra & you’l be flat & depressed...perhaps a self fulfilling profecy!
Vit B complex in B12 saved me did times to Keppra xxx

Submitted by Rebecca hall on

Why do I still get seizures if I am on medication? Also why do I get more seizures as the dosage increases?

Submitted by sabrina on

Dear Sarina 

Thank you for your question.

Many people with newly-diagnosed epilepsy respond well to epilepsy medicine and have fewer seizures. It’s not possible to say how long this will take. But for many people, it happens quickly. For others, it takes longer. Some people may need to try different epilepsy medicines before they find the one that works for them.

As you are still having seizures and they seem to be getting worse, I’d like to check you’re seeing an epilepsy specialist? An epilepsy specialist can review your treatment and look at other possible reasons for why this is happening. They may suggest trying a different epilepsy medicine.  If you have tried various types of epilepsy medicines, it may be the specialist could look into other treatment options for you.

If you are not under a specialist, you will need to ask your family doctor to refer you.

Regards

 

Diane

Epilepsy Action Helpline Team

Submitted by rich on

I’ve suffered with epilepsy for around 17 years, I take 400mg lamotrigine & 1000mg of keppra per day, About 4 days ago I’d ran out of my usual medications and my prescription wasn’t (still isn’t) ready to collect them so i could only take my lamotrigine but since then I’ve been having some strange side effects like constant ringing in my ears, very bad lathargy plus tunnel vision, panic attacks seem to be happening more and more also. I don’t know if I should seek medical attention in case it’s more complex than I thought or if I just need to ride it out. Please help?

Submitted by Gemma on

Hi Gemma

It sounds like you have been feeling pretty rough recently.

In order for your epilepsy medicine to work properly it really needs to be taken exactly as prescribed. Even missing a single dose can risk seizures.

What you are experiencing may be seizure activity.

Or it may be the sudden withdrawal of the levetiracetam.

Or it may be entirely unrelated.

 

It is probably best to mention these feelings to your family doctor just in case it is not related to your epilepsy.

Some people use reminders on their phone to make sure they don’t ever run out of their epilepsy medicines.

I hope this is useful information. and that you start feeling better very soon.

Regards

Cherry  

Epilepsy Action Helpline Team

Submitted by rich on

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