Different people are noncompliant with their medicines for different reasons. Here are some of the more common ones.

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 sur 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.

All Ages

Everyone with epilepsy needs to learn as much as possible about seizures from their doctor and from epilepsy.com and other reliable sources. Be sure you understand the importance of taking medication, and all about the medications. If you take medicine more than once a day, ask your doctor if there is another version that can be taken less often. The simpler your doctor can make your daily medication routine, the better!

Keeping good seizure control depends on taking seizure medicines regularly and as prescribed. Finding a way to keep track of them in easy-to-understand language will help you take them properly. Here’s what you can do:

• Collect all your pill bottles or prescriptions in one place.
• On your Seizure Plan (PDF), fill in the names of medicines that you take to treat seizures each day. Include only the critical information that may be needed in an emergency on this form.
  • Medicine name: Put the name of the drug on the pill bottle and if you take the brand or a generic form.
  • Total daily amount: Write down the total amount of each drug taken daily, using the strength of pills or liquid.
  • Amount of tab or liquid: Write down the strength of each tablet. If you have more than one size, include the strength of each tablet. If a liquid is used, write down the amount in teaspoons.
  • How taken: Write down how much medicine you take and the times they are taken.

You also need a way to remember your medicines each day. Use My Medicine Schedule (PDF) to keep track of all the medicines you take, and when to take them. You can include more detail here that will help you take the medicines on a regular schedule. Make sure to include all prescription medicines and over-the-counter products you take. Also include any medicine or intervention that is used for ‘as needed’ or rescue treatments. Here's the information you can enter:

• Name and contact information: Your complete name and how to reach you.
• Date: Date the form was completed and checked.
• Doctor: Name of the doctor who cares for your epilepsy and the number to call for medicine refills.
• Pharmacy: Name and phone number of the pharmacy used for your medicines.
• Medicine name: Name of the drug on the prescription bottle and note if brand or generic form.
• Purpose: Why you are taking the drug, either for seizures or a different condition. If you don’t know, take the form to your doctor.
• Amount: The strength or dose of each pill or liquid. If you have more than one pill strength for a drug, write them down on different lines.
• How prescribed: Exact instructions from your doctor, for example 1 pill every day, 2 pills twice a day, or 1 pill four times a day.
• When to take: First fill in the times that you take your medicine, then fill in exactly how many pills (or how much liquid) you take at each time for each medicine. This section is the one that you’ll look at each day so make it easy to understand!
• Total daily dose: The total dose or amount of medicine that you take each day. Use this as a way to double check that you are taking the right amount by comparing how you take the medicine with the instructions from your doctor.
• Allergies: All allergies to medicines and other substances, including environmental allergies.
• Devices: List any devices that are implanted in your body or that you use to treat any medical problems. This may include devices such as VNS Therapy, Deep Brain Stimulators, TENS stimulators (often used for chronic pain), or machines used to treat sleep apnea.

Make sure you review this chart with your doctor or nurse to make sure the information is correct and that you aren’t missing any information. A good idea is to have your doctor print out one of our information sheets on seizure medicines and customize it for you by adding any details about how he or she recommends that you take the medicine(s).  

Time flies, and it’s easy to run out of medicine, so be sure to have your medicine refilled before you run out of pills. And keep track of when the next refill needs to be called in by your doctor. Remember that the doctor’s office may not always be able to call in a refill on a moment’s notice, and that it takes time for a mail-order pharmacy to send you a refill, so plan ahead.

Use our Seizure Diary to help you know when to refill your prescription(s). If you are unable to drive and your pharmacy doesn’t deliver, then you need to make arrangements in advance to be sure your prescriptions are picked up (See interview with Professor Timothy Welty). Alternatively, look into a reliable and reputable mail-order pharmacy, such as the one offered to AARP members.

Topic Editor: Steven C. Schachter, M.D.
Last Reviewed: 6/1/08