Does missing medications cause seizures?

Yes, it can. Missing doses of seizure medicine is almost certainly the most common cause of so-called breakthrough seizures in people whose seizures are usually well controlled. It also can lead to prolonged seizures called status epilepticus, usually if medication is abruptly stopped altogether. Status epilepticus is life-threatening and requires emergency medical treatment.

Is it harmful to miss a single dose of seizure medicine?

It's quite common for people with epilepsy to miss a single dose once in a while. Often nothing bad happens but your chance of having a seizure may be increased. Missing one dose is more likely to cause seizures if you're scheduled to take your medicine only once a day. Then if you miss a dose, you've missed a full day of medication. If you take it two to four times a day, the risk from missing one dose is less. But if you miss several doses in a row, the likelihood of a breakthrough seizure will be higher. Read more about missing doses.

What strategies can help prevent missing doses?

• Use activities that you perform every day—things like brushing your teeth, taking a shower, or having meals—as cues to remind you to take your medicine.
• Use a pillbox that organizes your pills by day of the week and time of day. Then you can tell at a glance whether you have forgotten a dose.
• If you still have trouble remembering, consider getting a pillbox or wristwatch that will sound an alarm when it's time for your next dose.
• Don't wait until you are out of pills before refilling your prescription. Keep at least a one- to two-week supply on hand. If you have no refills left, it's especially important to call the doctor before you run out. If you do run out of medicine, do whatever is necessary to get more right away, even if you have to go to an emergency room.
• If you order your seizure medicine by mail, get a spare two- to four-week supply.
• Keep an "emergency" supply at work, in your purse or wallet, or perhaps in your car in case you don't get home in time for your next dose. (Be sure to replace these pills regularly, especially if they're stored someplace that gets hot, like the car.)
• For children, have the school nurse or teacher keep some medication on hand.
• When traveling, pack two supplies of your seizure medicine, in both a carry-on bag and your checked luggage.
• If you travel across time zones, take the same amount of medication over a 24- or 48-hour period as you would if you were at home, with about the same intervals between doses.

What would happen if I decided to stop taking my seizure medicine?

Choosing to stop taking your medication without a doctor's advice is dangerous. Abruptly stopping some seizure medicines can cause withdrawal symptoms. You could have prolonged tonic-clonic seizures even if you have never had them before. If you're taking two or more seizure medicines and stop taking just one of them, the levels of the others in your blood may change dramatically. This could reduce their effectiveness or cause serious side effects. Never stop taking a seizure medicine without talking about it with your doctor first.

Topic Editor: Steven C. Schachter, M.D.
Last Reviewed:11/20/06