Skipping Epilepsy Medications May Have Bad Consequences

The Danger of Skipping Your Epilepsy Drugs

Man taking medicine
What can happen if you skip your epilepsy medications?. Getty Images/Paul Bradbury

If you have epilepsy, it's important to know that skipping a dose of your medications can be dangerous. Yet just how serious can this be? Let's take a look at what the studies tell us, and offer some tips on remembering your medications. After all, we don't want you to become one of these statistics.

Epilepsy Medications

If you have epilepsy, you are more than likely taking medication to control your seizures.

Most people with epilepsy have taken medications for other conditions in the past. With many medications, however, missing a dose or two isn't terribly serious. For example, if you skip a day or two of your cholesterol medication it's not likely to be a problem. With some drugs, the missed dose might be a little more significant. For example, if you skip your antibiotic your infection may last longer. Yet with some other drugs, such as those designed to prevent a heart attack, and of course, those to prevent a seizure, missing even a single dose can have devastating effects.

That said, remembering to take your medicine—especially if you take more than one medication or take your medicine multiple times a day—can be a problematic task. Although it might seem OK to skip a dose, keep this in mind: missing just one dose can cause you to lose control of your seizures.

As a little reinforcement, let's talk about what studies tell us happens when people miss a dose of their epilepsy drugs.

Just like those who put on their seatbelts after witnessing a car crash, understanding that the risk is not just theoretical may help motivate you to take your meds regularly.

Consequences of Skipping Epilepsy Medications

Let's first list out some of the consequences which have been documented when people skip their anti-epilepsy drugs, and then talk about the risk of these consequences.

Risks of skipping seizure meds include:

  • More emergency room visits
  • More hospitalizations
  • More care accident injuries
  • More fractures
  • More deaths

Now, let's talk about how often these things happen.

Study Quantifying the Danger of Skipping Meds Can Be Dangerous

A scary study published in the June 2008 issue of Neurology suggests that skipping your antiepileptic medications can have devastating consequences, including death.

For close to 10 years, the study followed the medical records of over 33,000 people with epilepsy. The investigators looked at the consistency in which people took their medication, as well as the number of injuries, fractures, visits to the emergency room, and hospitalizations that occurred during the study. People were considered "adherent" to their medications if they took their medication correctly (no missed doses) at least 80 percent of the time.

The study found that not taking antiepileptic medications on a daily basis were 3.32 times more likely to die than those who took their medications regularly. In addition to this 3-fold increase in mortality, those who did not take their medications regularly:

  • Had 50 percent more emergency room visits for their epilepsy
  • Had almost twice the rate of hospitalizations
  • Were twice as likely to be injured in a motor vehicle accident
  • Were 20 percent more likely to sustain a fracture.

The importance of this study cannot be stressed enough. There are many reasons why people do not take their medications regularly ranging from cost, to side effects, to denial. Yet most discussions focus on the reason why medications may be missed, rather than the very real dangers of what may occur when those medications are skipped.

How to Not Forget Your Epilepsy Medications

If you are having problems taking your medications, some of the following tips may be helpful to you:

  • Purchase an inexpensive pill organizer at a pharmacy if you take more than one medication to control your seizures. If you do use pill boxes, however, make sure you are using them properly. In general, it's best to keep all medications in their original containers. Keeping a pad of paper in which you check off your medications as you take them may also be helpful. The important thing is to have some type of system which jogs your memory and gives you a visual reminder of whether you have taken your medication or not.
  • If you are prone to forgetting to take your medicine, set an alarm on your watch, on an alarm clock, or even your oven to remind you to take your medication. In time, remembering your medication may become more of a habit. Don't be afraid to enlist someone such as a spouse to remind you as well, at least early on.
  • For technophiles, consider using one of the medication-related apps that are now available.
  • Never stop any medication before discussing it with your healthcare provider. This includes before surgeries. Sometimes people are told not to take medications on the day of an outpatient surgery as a part of not eating or drinking. Unless your neurologist specifically states that you should not take your medication, seizure medications should be continued with a small sip of water.
  • If you are having side effects from your seizure medication, talk to you doctor. There are several different options available for those who have seizures, but it's important to have you doctor advice you on how to switch from one medication to another.
  • If you are unable to afford the medication, talk to your doctor as well. There are many options. Some pharmaceutical companies offer discount plans based on income. Your doctor may be able to switch you to a less expensive medication as well.
  • If you develop nausea and vomiting for any reason such that you are unable to keep down your medicines, contact your neurologist immediately. Sometimes intravenous seizure medications are needed until you are able to take oral medications again.
  • Keep your refills up to date. Always try to refill your medication three to four days ahead of time (and longer if you receive mail order prescriptions.) This can help to avoid missing any medications due to holidays. If you are planning a trip, talk to your pharmacist well ahead of time, as some insurance companies will not allow early refills. If you will be out of town when the time comes to get your refill, you could end up missing medications. Talk to your pharmacist who can help make arrangements with your insurance company for a one time exception.
  • Check out these additional tips on how to remember your medications.

The Bottom Line on Skipping Your Epilepsy Medications

This study shows that taking your medications as prescribed and on a regular basis will not only help you to get better control of your seizures, it will also help you to avoid accidents, fractures, visits to the hospital, and even death from a seizure-related event.

If you are struggling to remember your medications, try the tips listed above or talk to your doctor. Sometimes a little inconvenience in the short run is by far preferable to the major consequences which could occur in the long run.

As a final note, in addition to the complications of missing medications, there are close to 700,000 emergency room visits each year due to adverse drug reactions. Learn more about how to avoid medication errors.

Sources:

Al-Ageel, S., and J. Al-Sabhan. Strategies for Improving Adherence to Antiepileptic Drug Treatment in Patients with Epilepsy. Cochrane Database of Systematic Reviews. 2011. (1):CD008312.

Faught, E., Duh, M., Weiner, J., Guerin, A., and M. Cunnington. Nonadherence to Antiepileptic Drugs and Increased Mortality: Findings from the RANSOM Study. Neurology. 2008. 71(29):1572-8.

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