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Epilepsy Medicine Therapy Failure

Topic Overview

Medicine therapy for epilepsy can fail for several reasons:

  • You do not follow the treatment plan. You have to follow your therapy routine exactly as your doctor orders, to have the best chance of keeping seizures under control. Missing a dose here or there or taking doses too close together can upset the levels of the drug in your body and lead to seizures, severe side effects, and other health problems. If your treatment is not controlling your seizures, your doctor will go over your treatment plan with you to make sure that you not only understand it but also are following it. The main cause of treatment failure is due to not following the treatment plan. Over half of all people with epilepsy have trouble following their treatment plans.1
  • Misdiagnosis of the condition. You may be having events that look like seizures but are not. You may be having seizures, but something other than epilepsy is causing them. Taking antiepileptic drugs when you do not have epilepsy may not stop you from having seizures. If you do have epilepsy, the diagnosis of your seizure type may still be wrong. Seizures are hard to describe and hard to classify. Mistakes in identifying the types of seizures you have can lead to choosing the wrong drug. A drug that prevents one type of seizure may not work for another type or may even make seizures happen more often.
  • The drug has too many adverse effects. Seizure control is not the only measure of success. You may be free of seizures, but the side effects of the drug may be so severe that you cannot take the drug anymore.
  • You have a condition that won't respond to drugs (a medically refractory, or intractable, condition). Some people have forms of epilepsy that simply will not respond to drug therapy. About 3 out of 10 people continue to have seizures despite careful drug treatment.1 Some of these people may be candidates for epilepsy surgery. Others, particularly children, may respond well to a ketogenic diet. If drugs do not control your or your child's seizures, you and your doctor may want to look into other treatment options.

There are several reasons people may not take their medicine as prescribed:

  • They may forget or neglect to take medicine or to refill their prescription. This may be the result of normal forgetfulness, although memory problems or confusion may also contribute to it.
  • The guidelines for when and how they are to take medicine may be too complicated.
  • They may be afraid to take medicine because of short- or long-term side effects. Women who are pregnant or planning to become pregnant may fear what effects the medicine will have on the baby.
  • They may not be able to afford the medicine.

References

Citations

  1. Schachter SC (2003). Epilepsy: Etiology and manifestations. In RW Evans, ed., Saunders Manual of Neurologic Practice, part VII, pp. 244–265. Philadelphia: Curtis Center.

Credits

By Healthwise Staff
Primary Medical Reviewer Susan C. Kim, MD - Pediatrics
Specialist Medical Reviewer Steven C. Schachter, MD - Neurology
Last Revised August 26, 2011

Last Revised: August 26, 2011

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