Sometimes, the first seizure medicine you try doesn’t control seizures, even if you followed all the directions. If that happens, what should you do next?

Don’t give up! There are lots of medicines and treatments for seizures, and sometimes it takes a while to find what’s best for you.

What should I do if the first medicine doesn’t work?

  • Keep a record of your seizures and tell your doctor how often you are having seizures. 
  • Write down anything that might affect or trigger your seizures. For example, after a seizure, write down:
    • What time of day it happened
    • If you forget to take your medicine
    • Whether you were sleeping when the seizure happened
    • If you had been getting enough sleep
    • If you were under a lot of stress
    • If you were sick with another illness
    • How you were feeling at the time
    • What you were doing at the time
  • Review your list of triggers with your doctor. You might be able to make changes in your life to help control your seizures.
  • Go over how you’re taking the medicine. Tell your doctor if you’ve missed any doses. There may be an easier way to take your medicine.

What happens next?

Your doctor might suggest making a change to your medicine. You might try:

  • Taking a higher dose of the medicine, or taking it at a different time of day. If you do this, make sure you understand the new way to take your medicine. Write down what changed.
  • Taking a different kind of medicine. To do this, you’ll start the new medicine, and then gradually stop the first medicine.
  • Adding a second medicine to the first one. Some people do better on a combination of medicines than on just one medicine.  

Remember, no single medicine or combination of seizure medicines is best for everyone. You may need to try different medicines to find which one works best for you.

What if the next medicine doesn’t work either?

Most people get a good response to the first or second seizure medicine they try. If you’ve tried 2 or more seizure medicines and you’re still having seizures, it’s time to get more help from an epilepsy specialist.

If you are seeing a primary care doctor, ask to see a neurologist (a doctor who specializes in disorders of the nervous system, including the brain) or an epileptologist (a neurologist who specializes in epilepsy).

If you’ve already been seeing a general neurologist, ask to see a neurologist who’s also an epilepsy specialist.

An epileptologist or epilepsy specialist can help you:

The epilepsy specialist may become your primary neurologist (the main doctor managing your seizures). Or, you may continue seeing your general neurologist as well. In that case, the epilepsy specialist and your general neurologist will talk to each other about their recommendations for you.

It’s important that your primary care doctor and your epilepsy doctors talk to each other about your care, so everyone knows what’s going on.


Authored By: 
Patricia O. Shafer RN, MN
Authored Date: 
Monday, October 27, 2014
Reviewed By: 
Joseph I. Sirven MD
Reviewed Date: 
Tuesday, October 28, 2014