“Did I swallow my medication? Did I miss a dose?”
If you live with epilepsy, these are questions you’ve probably asked yourself many times. I certainly have. Even the most disciplined Persons With Epilepsy (PWEs) sometimes find themselves unsure whether they took their last dose—mainly because many anti-seizure drugs (ASDs) can affect memory.
It might sound like a small thing, but this moment of uncertainty can have serious consequences. The dilemma is simple but dangerous:
Do you swallow another dose just to be sure, risking an overdose?
Or do you skip it in case you already took it, risking a missed dose?
Both choices carry real risks.
If you skip the dose when in fact you didn’t take it, you’ve effectively missed a dose. And missed doses are one of the most common causes of breakthrough seizures. Many PWEs who are otherwise stable suddenly experience a seizure simply because they accidentally skipped their medication.
On the other hand, if you swallow the dose twice, your drug levels can rise too high, leading to toxicity and worsening side effects like dizziness, nausea, extreme drowsiness, or even more severe reactions depending on the medication.
This situation is so common that there has to be a practical solution. Over the years, I’ve found that the safer option is usually to assume you missed the dose and take it. Yes, this may increase the chance of temporary side effects or mild toxicity. But in my experience—and for many others—the risk of a missed dose leading to a seizure is often more dangerous than a slightly higher blood level for a short period.
That said, this is not a situation you should face often. At Seizure Support, through both the Epilepsy Management Guide (EMG) and the Patient Portal, we strongly emphasize the importance of having a consistent medication reminder system. This could include:
- Setting alarms on your phone
- Using daily routines tied to specific times
- Pill dividers with clearly labeled days and doses
- Asking a friend or family member to remind you
The goal is simple: never be in a position where you have to guess whether you took your medication. Guessing can lead to either toxicity or a breakthrough seizure—both of which are avoidable with the right systems in place.
This issue is discussed in detail in the Epilepsy Management Guide, which you can download for free. To participate in the discussion on this topic, visit the Global Epilepsy Forum. To know more about what we do, please click HERE. We also have a donation page where those who feel compelled can give whatever they can afford by clicking HERE.
