Drug-Resistant Seizures

Having ongoing seizures does not always mean epilepsy is drug resistant. There are several possible reasons.

1. The Diagnosis May Be Incorrect

Some medical conditions can look like epileptic seizures. If seizures are not responding to treatment, doctors may first confirm that the episodes are actually caused by epilepsy. In one study, about 1 in 8 people referred for drug-resistant epilepsy did not have epilepsy, showing that a second look at the diagnosis can sometimes be helpful.

2. The Treatment May Need Adjustment

Different types of seizures respond to different medicines. A medicine that works well for one type of seizure may not work for another.

Seizures may also continue if:

• The medicine dose is too low
• Side effects limit treatment choices
• Medicines interact with each other

An epileptologist can review your treatment plan and make changes if needed.

3. Medicines May Not Be Taken Consistently

Missing doses is one of the most common causes of breakthrough seizures.

Record your medication schedule by using tools such as pill organizers, reminders, or phone alarms. It can be helpful to link the time you take your pills to another daily habit (like a meal or brushing teeth).

4. Seizure Triggers May Play a Role

Many people have triggers that make seizures more likely.

Common triggers include:

• Lack of sleep
• Stress
• Missing medicine doses
• Hormonal changes
• Illness
• Alcohol use
• Recreational drug use

Learning how to identify triggers and doing your best to avoid them may help improve seizure control. You can also learn other skills for managing your condition and overall health. The Chronic Disease Self-Management Program (CDSMP) offers real-life steps to manage your health. 

5. The Epilepsy May Truly Be Drug Resistant

In some cases, seizures continue even when the diagnosis is correct, medicines are appropriate, and treatment is followed carefully. This is considered true drug-resistant epilepsy.