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The good news is that for approximately 2 out of every 3 people with epilepsy who take their seizure medication as prescribed, the medicine successfully prevents more seizures from occurring.

But that means that 1 in 3 people with epilepsy who take a seizure medicine may have recurrent seizures, even when they take the medicine correctly.

If your seizures continue, your doctor should do one or more of the following things to figure out why you continue to have seizures:

• Check to see if you have been taking your medication as directed.
• Take a blood test to see the blood level of your epilepsy medication.
• Increase your dosage, unless you are already having side effects.
• Change your medication to a different seizure medication if raising the dose of your current medicine is not possible. The new medication might replace the one you’ve been taking or be added to it.
• Educate you further about changes in lifestyle you can make that might reduce seizures.
• Refer you to a doctor who specializes in care for epilepsy patients.

Whenever you see your doctor for a follow-up visit to discuss your seizures, your doctor should ask you to estimate how many seizures you have had since your last visit and whether you are having any side effects from your seizure medicine(s). It is helpful to keep a seizure diary so that you can record this information accurately in between your doctor visits.

People with epilepsy should see their doctor at least once a year to discuss how they are doing, even if their seizures are completely controlled. Topics that should be discussed at the visits include:

• The long-term effects of both epilepsy and seizure medicines including drug side effects, drug-drug interactions, and effects of seizure medicines on bone health
• Contraception, family planning, and how pregnancy and menopause may affect seizures
• Screening for mood disorders, including depression
• Seizure triggers and lifestyle issues that may affect seizures
• Impact of epilepsy on other medical diseases
• Driving and safety issues
• How to manage having epilepsy

As many as 1 in 3 people with epilepsy have depression or anxiety or both. If your doctor diagnoses you with either depression or anxiety, or both, then you should receive treatment for it or be referred for mental health care. Be sure to discuss your moods with your doctor during your visits, even if you think they are unrelated to your seizures or your medications.

If you have been taking seizure medicines for 2 or more years, then your doctor should run tests to evaluate the health of your bones. Long-term exposure to seizure medicines may result in thin bones in some people, putting them at risk for bone fractures.

If your seizures have not stopped despite trying two different seizure medicines, then your doctor should refer you to a more highly specialized center for epilepsy care.

For more information:

• Tracking and Treating Seizures
• Managing Continued Seizures
• Seizure Diary
• Public Enemy #1: Depression and Mood Disorders in People with Epilepsy
• Side Effects
• Find an Epilepsy Center

Topic Editor: Mary Jo V. Pugh, PhD, RN and Steven C. Schachter, MD.
Last Reviewed: 7/29/08