Medication does not cure epilepsy but it can prevent seizures occurring and control them when they do.
Whether or not to prescribe medication will depend on how highly the doctor rates the risk of another seizure and how severely a seizure would impact on the person’s life.
Medication and epilepsy in the later years
Medication should always be taken in accordance with the doctor’s instructions to maximise the beneficial outcomes of the medication and to prevent unwanted side effects. Around 70% of people with epilepsy can have good seizure control if they take their medication correctly.
There are two types of medications that can be prescribed for epilepsy:
1. Antiepileptic drugs (AEDs). AEDs are the most common treatment for people. While, they will not cure epilepsy, they can control seizure activity. AEDs are usually prescribed based on:
- how well they work for the person’s seizure type/s
- how well the person can tolerate them
- what other health-related conditions the person may have
- what medications are already being taken
- how seriously the seizures are affecting the person’s life.
There are many different types of AEDs available. A seizure free outcome is the optimal result sought for the older person and by the doctor.
2. Emergency Medication. For epilepsy, emergency medication works by stopping the seizure activity if taken when a seizure occurs. Emergency medication reduces the impact of seizure activity on the person’s life. What does this mean for the older person? Commencing medication does not always mean that it must be taken forever, there are a few things that need to be considered:
- Understanding why the medication has been prescribed.
- Regular medical reviews as medication may only be needed for a limited time.
- Always taking medication in the dosage and at the time recommended by the doctor. General advice is that if a dose is missed it can generally be taken as soon as you remember. Do not double up on doses. It is advisable not to take the missed dose if it is close in timing to the next one. Keep a record of doses that have been missed.
- After starting medication it is important to note any changes in general health or seizure activity. If the medication is not managing seizure activity the doctor should be advised as soon as possible as the medication or dosage may need to be changed.
- Withdrawing from medication should always be carried out under medical supervision as stopping medication can provoke seizures and can potentially create a medical emergency.
It is quite common for people in their later years to have other health conditions which may require medication. This may have an impact on what type of AED can be prescribed. People in their later years also experience differences in the way drugs are absorbed and broken down (metabolised) or cleared from the body.
It is good practice to ask the doctor to discuss the risks and benefits of all medication. The doctor will describe common side effects of the prescribed medication; however it is also good to ask the pharmacist to go through any possible side effects.
- Like any medication AEDs can cause some possible undesirable side effects, including: skin rashes, falls, difficulty concentrating or thinking, or problems with memory. People in their later years are more susceptible to side effects.
- AEDs can contribute to osteoporosis – a condition of decreased bone strength (thinning of the bones) which increases the risk of a broken bone. If taking AEDs for an extended period, bone density assessments may be necessary.
If the older person is having many seizures, or seizures which last a long time, the doctor may also prescribe emergency medication:
- The doctor will advise when the emergency medication is to be administered, how it is to be stored and how it is to be administered.
- Emergency medication information will be recorded in an Emergency Medication Management Plan (EMMP).
- Only medical practitioners or people who have been trained to administer emergency medication in accordance with this plan should do so.
What can you do to help?
AEDs may interact with other medications.
Other medications may impact on the effect of AEDs. Understanding medication, their side effects and impacts can be overwhelming for many people. Support with understanding the role of medication in the person’s Epilepsy Management Plan (EMP) is important. Encourage the older person to ask for more information and discuss the options with their doctor, family, close friend or carer if concerned.
Medication continuity is essential and it can be easy to forget to take medication at the appropriate time. Encourage the older person to put strategies in place to remind them to take their medication:
- Use a pill box or Webster Pack. This is useful particularly if taking numerous medications. It also reduces the chance of double dosing.
- Encourage the older person to establish a routine and combine taking of medication with a daily task such as brushing teeth or with meals.
- Keep medication in an easy to see place so they cannot be missed
- Encourage mindfulness – discuss the importance of pausing and being present when taking medication, to ensure the correct dose is taken.
- When supporting an older person who has been prescribed emergency medication it is important to receive training in Administration of Emergency Medication.
- Use technology. Set up reminders on the person’s phone, watch or electronic calendar. There is also a range of apps available for smart phones.
- Encourage the older person to complete the Medication summary form on the next page.
Where to go for further information?
www.epilepsyaustralia.net Search: Epilepsy treatment
Victoria Government, Better Health Channel
www.betterhealth.vic.gov.au Search: Safe medication use
Australian Government, Department of Health
www.health.gov.au Search: Guiding principles for medication management in residential aged care facilities
This information is part of a suite of resources that are targeted to aged care workers and carers of older people, to assist with caring for older people living with epilepsy.
The information contained in this publication provides general information about epilepsy. It does not provide specific advice. Specific health and medical advice should always be obtained from an appropriately qualified health professional.