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.
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 NHS Choices 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.
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 2017To be reviewed May 2020