Hardly anybody likes taking medications. They are a hassle to remember, and taking them may be embarrassing or may disrupt other, more pleasant activities. When doctors recommend a treatment, they assume that the patient will follow their instructions. Doctors call this "adherence." It's common for people not to take medications as prescribed, however, for many reasons. One important reason is that the patient and family have not been involved in planning the treatment. They should be told about the possible choices of therapy, their benefits, and the common minor or troublesome adverse effects, as well as the rare but serious adverse effects of seizure medicines. Communication is the key. A plan that's easy to follow, such as taking a dose just once or twice a day, is also critical in improving adherence.

Young children may require adaptations in giving their medicine to ensure that they take it all. 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. 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. They might take a vitamin so the children can copy their behavior. Children love to imitate their parents. Caution: Keep all medications out of the reach of young children.

Many children and adolescents 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 a food or taken just when a mouthful of food has been chewed ("to a pulp") and then swallowed. Discussing your child's ability to swallow medication with their neurologist will allow them to select a medication formulation your child can take.

When a child with epilepsy will be away from home, whether visiting the grandparents for the weekend 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 (800-722-8824) 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, because compliance is so important. As soon as children are old enough (for most children by age 9-11 years), they should be active participants in filling their medication box, with parental supervision.

Topic Editor:James W. Wheless, M.D.
Last Reviewed:10/5/06