Special medication management issues arise with children and adolescents:

Children

Hardly anybody likes taking medications - especially kids. Taking medicine may be embarrassing to children, particularly at school, or may get in the way of other, more pleasant activities.

But even small children can understand the importance of taking their pills. Young children can be told that it will help keep them well. Older children can understand that they are taking their pills so they will not have seizures. Parents may want to use themselves as an example. They can show their children that they occasionally take an aspirin when they have a headache, or can show how they take regular medicine for their high blood pressure. If they don't take prescription medications, they can take a vitamin so their children can copy their behavior. Children love to imitate their parents. Caution: Keep all medications out of the reach of young children.

In addition, many children may require special help to be sure they take all their medicine, especially if they feel that they are unable to swallow medication in a tablet or capsule form. Although chewable sprinkle and liquid formulations of most medications are available as a substitute, a child can practice taking tablets or capsules by learning to swallow a whole M&M, Reese Piece or Tic-Tac candy with a chewed-up cookie. Alternatively, the pill can be placed on the back of the tongue and taken with water or juice from a glass rather than bending over a drinking fountain. Medication can also be mixed with food or taken just when a mouthful of food has been chewed ("to a pulp") and then swallowed. (Be sure to check with your doctor to see if the medication can be taken with food). It may be necessary to crush the pills and put the powder in the child's favorite foods, or to give the child a small reward if he or she takes the pills. Discussing your child's ability to swallow medication with his or her doctor will allow the doctor to select a medication formulation your child can take.

When a child with epilepsy will be away from home, such as visiting family members or going to camp for the summer, it is essential to maintain the medication schedule. The child, parent, or both can organize a medication box filled with the necessary number of doses and the times for taking them. Alternatively, a company called Medicine-on-Time will bubble-pack individual medication doses and label them by date and time. Whatever procedure is used, it should be one that the child or responsible adult understands and finds easy to use. As soon as children are old enough (which for most children would be by age 9-11 years), they should be active participants in filling their medication box, with parental supervision.

Adolescents and Teenagers

With the maturity that adolescence brings, most children become more aware of the benefits of taking their seizure medicines. But for some teens, rebellion from authorit or denial that they have epilepsy dominates their thinking and behavior, making them less likely to take their medications as prescribed, if at all (See PDF of Seizures and Teens: The Practical Aspects of Managing Seizure Medications). It is essential, therefore, to repeat in early adolescence the reasons for taking the seizure medicines that were taught during childhood. Teens are normally able to understand the consequences of taking or not taking their medications. Education about seizure medicines can come from both the parents and the doctor, but the teen should be enlisted as an active partner in his or her treatment. Teens with epilepsy should be allowed to take greater responsibility for managing their care. It is often helpful for the teen and the doctor to be alone for a portion of each visit or even the whole visit. This makes the teen feel more in control and more mature and helps to establish trust with the doctor and the parents.

One of the most powerful factors in securing a young person's compliance is peer pressure. The teen's desire to conform is strong. Seizures can be embarrassing and cause fears of social isolation. Further, uncontrolled seizures can result in restrictions on certain activities such as driving. Teens should know that the longer they are free of seizures with medications, the better the chances are that they will be seizure-free without medications.

Steven Schachter, M.D.

Continue to How to Plan Your Medskills© Program

Section Editor: Robert Fisher, M.D., Ph.D., author: Joyce Cramer
Last Reviewed: 11/15/08