A Parent's Story

"I know Steve doesn't take his medication regularly. I try to remind him every morning and every night. It's more than forgetting. By not taking his medications, he is saying, 'I don't really have epilepsy.' I hope he realizes that he won't be able to drive if he still has his occasional complex partial seizures."

The maturity that adolescence brings should make children more aware of the benefits of taking their seizure medicines. For some teens, however, rebellion or denial dominates the scene, making them less likely to take their medications as prescribed. 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 child'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.

With older children and teens, the easiest and the best assessment of compliance is simply to ask them straight out: "Are you taking your medicine?" Measuring the level of seizure medicines in the blood at regular intervals can tell the doctor and the parents if the teen is taking the medications as prescribed and can reinforce compliance. However, there are at least three instances when levels may be low even when medication is taken regularly; for example, 1) a period of rapid growth in height and weight,2) interaction with another new medicine (not necessarily for treatment of epilepsy) or,3)in rare cases, problems with absorption or metabolism.This is why it is critically important to notify the neurologist if any new medication is begun.

 

Authored by: James W. Wheless, MD | Joseph I. Sirven, MD
Reviewed by: Joseph I. Sirven, MD on 8/2013
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