Topic Overview

While working with your doctor to plan a medicine routine for yourself or your child, it may help you to talk about some of the choices and issues involved. Some of the following questions might help you prepare.

How often will I or my child have to take the medicine?

Some medicines for epilepsy have to be taken several times a day. This is sometimes hard for children in school; people with busy, irregular schedules; and people who have a hard time remembering to take their drugs. People who have fewer daily doses may be more likely to follow the treatment plan. Talk to your doctor about what to do if you miss a dose.

How will the medicine's side effects affect my lifestyle?

All antiepileptic medicines have side effects, but some may have side effects that are more acceptable to you or your child than others.

• It may be hard to get your teenager to take a medicine that causes weight gain, hair loss or growth, or acne.
• Some medicines can cause mood swings, memory loss, or depression. But others may not affect your state of mind.
• Job-related issues might be important. For instance, if your job requires close, steady work, you may want to avoid a medicine that causes your hands to shake or affects muscle control.

What health risks come with using the medicine?

Allergic or toxic reactions in the skin, liver, and blood may sometimes result from use of antiepileptic medicines. Your age or medical history may make you more likely to have one of these adverse reactions. Long-term use of antiepileptic medicines, while often needed, may cause other health problems. Ask your doctor to discuss the short-term and long-term risks of the medicine.

How will the medicine react with other medicines I take?

Many medicines for epilepsy can interact with other medicines you may be taking. This means that your epilepsy medicine may not work as well, or it may affect the way another medicine you are taking works. Some of these interactions can be dangerous. It is important to tell your doctor about all the medicines or natural health products, such as herbal pills, or dietary supplements you are taking.

If you have several types of seizures, you may need to take more than one medicine to control them. The doctor will work with you to choose medicines that will neither work against each other nor make side effects worse. If you take medicine for health problems other than epilepsy, the doctor should choose an antiepileptic medicine that will not react badly with your other medicine. This is a special concern for older people, who are more likely to be taking several medicines.

Some antiepileptic medicines can make birth control pills less effective and make a woman more likely to become pregnant. A woman taking birth control pills may need to change the dosage or use a different type of birth control.

How much will the treatment cost?

The costs of medicines vary. Epilepsy often requires many years of treatment. If you can, choose a medicine that you will be able to afford over the long run. High costs may make you less likely to stay on your treatment plan. In most cases, the cost of epilepsy medicines is covered under your provincial health plan.

Try to keep the total costs in mind. Medicine may be expensive, especially with some of the newer antiepileptic medicines. But successful treatment may also help you lower your total costs by reducing doctor visits, hospitalization, and missed work time. A medicine that controls your seizures and does not cause many side effects may be worth the cost.

What if I become pregnant? How will the medicine affect me and my baby?

All medicines for epilepsy have some risk of birth defects. But the risk of birth defects needs to be carefully compared to other risks to the baby if the mother stops taking her epilepsy medicine. If you are thinking about becoming pregnant, it is important to plan ahead and talk with your doctor about the benefits and risks of taking epilepsy medicine during your pregnancy. It you are already pregnant, it is not too late. The best thing to do is talk to your doctor about your pregnancy before you make any changes to the medicines you are taking.

Although most women with epilepsy deliver healthy babies, the risk of birth defects, stillbirth, and seizure problems is higher for women who have epilepsy. Most antiepileptic medicines increase the risk even more, but stopping use of the medicine is not always the best solution. You may start having more seizures if you stop taking your medicine, and having seizures during pregnancy can harm the baby.