Epilepsy Ontario :: Medications for Seniors with Epilepsy

Medications for Seniors with Epilepsy

Seniors may take several medications, both prescription and non-prescription, at one time. The distribution of any drug in the body changes with age as the body fat content increases and muscle mass decreases. As a result, the absorption, distribution, metabolism and excretion of medications are all affected. This is why checking the level of medication in your blood regularly becomes important as you grow older.

Everybody reacts differently to medicine; some people are more sensitive to the effects of a drug than others. Consequently, antiepileptic drugs (AEDs) have different effects on everyone. You may find that your AED has reduced the frequency and severity of your seizures, or perhaps it has stopped seizure activity completely.

Choosing an antiepileptic Drug

Choosing the right medication takes time and a willingness to be open and honest with your doctor. You and your health care provider must have a common understanding of your general health and the nature of every medication you are presently taking. Some drugs should not be taken simultaneously. This means that your doctor will have to know your entire medical history in order to prescribe the right medication for you.
Communication with your family and caregivers is most important. Your partner, adult children and caregivers should understand the goals of your treatment, the possible side effects of your AEDs, and your monitoring strategies. Communicating clearly will eliminate confusion and feelings of helplessness when you need support.

Everyone's AED dosage may be different, depending on the severity of their seizures, the other drugs they are taking, and allergies. If you are not completely honest about your medical history, the dosage prescribed may be wrong and could be a dangerous amount. With the wrong prescription, you may experience symptoms of sedation and/or hyperactivity, a disruption in vision and balance, and states of confusion, among other side effects.
It is always a good idea to carry a list with you of the medications you are presently taking.

Do Not Stop Taking your Medication without Consulting your Doctor First.

Abruptly stopping an AED may cause serious rebound seizures and can even be life threatening. If you are experiencing problems with your AED, talk to your neurologist about it. You may consider other treatment options together.

Compliance — Remembering your Medication

Multiple medications can be overwhelming, especially when they must be taken at scheduled times every day. Sometimes it is too easy to forget the last time you took your medication or when the next dosage should be taken. To avoid missing dosages or double dosing, try using memory aids. Your family and friends can assist you.

Suggestions for Memory Aids

Use divided, labelled pill containers. If you cannot find one that suits your needs, label it yourself.
Wear a wristwatch with an alarm set to sound when you should take your next dose.
Try to make a routine: if you need to take a pill when you wake up in the morning, always bring one to the breakfast table with you.
Post a schedule of what medications you should take and when to take them.
Home Support Services can always help you if you need someone to remind you to take your medication. The service can be provided through the Community Care Access Centre in your area.
Schedule more frequent visits to your doctor as a motivator to stick with your drug regimen.
If these strategies fail, consult your physician. It may be possible to switch to another AED with a simpler dosing regimen.

Sometimes medication is not taken properly for reasons other than memory.

Many seniors find it difficult to read small print, as is always found on the label of a pill container. If this keeps you from reading the instructions to take your medication, ask your doctor and pharmacist if it is possible to use large print on the label.
To avoid confusion, ask for the prescriptions to be fully and clearly labelled. Usually, a pamphlet or information about the drug is given to a patient. Make sure you are given the information you need to know.
If you have arthritis, ask for a container with a cap that is easy to open.

Financial constraints sometimes force seniors to withhold food as well as their medication. People on low or fixed incomes who have small pensions often try to make their medication last longer by taking fewer pills than they are supposed to.

If you are suffering from this problem, tell someone. Your doctor may be able to suggest something. Perhaps you qualify for certain government pensions you do not know about. Either way, your medication must be taken as directed in order to stop the seizure activity.

Risks in Taking Multiple Medications

On average, seniors take approximately 7 drugs a day. As you grow older, taking multiple medications becomes more of a risk. This need not be a problem, though: careful planning on your doctor's part will result in proper treatment. Agreeing to take proper care with your medications on your part should yield better health.

Factors when Taking Multiple Medications

Physical/Physiological Changes — With age, the liver becomes less efficient at breaking down drugs and the kidneys may be less efficient at excreting waste. This can result in drug accumulation in the body. Other physiological changes may affect sleep (Medications may make a person need to sleep more.), sexuality (Some AEDs affect sexual function.) and overall nutritional (Appetite alters with medications, as well as with age.), and metabolic patterns.
Drug Interactions — Other medications can increase the likelihood of drug interaction. As the body ages, changes occur in the immune system and in the ratio of body fat. As well, the brain and the nervous system become more sensitive to drugs. These factors increase the likelihood of adverse drug reactions.
Compliance — Some seniors may not be able to take proper care of their medications. Misuse may result from misinformation about the drug or vague instructions about its use. A declining memory and intellect due to aging also contribute to the misuse of antiepileptic drugs. Some seniors may not be able to remember whether they have already taken their medication at the proper time, bringing the risk of double dosage. Furthermore, if a senior is taking multiple medications in addition to AEDs, which is very common, general confusion and temporary memory loss may arise, especially if one of the drugs taken is sedative.

For first aid procedures, see First Aid for Seizures.

For information about specific AEDs, see Anti-Epileptic Medications.