Epilepsy – Is there a need to adjust or increase the dosage of medication if I continue to have seizures?

  1. Do I need to adjust or increase the dosage of medication if I continue to have seizures during the medication?  A: If seizures occur again during the course of medication, it is necessary to assess whether there are obvious triggers for the seizures, such as recent fever, diarrhea and other infections, and if there are triggers, continue to observe the seizures when the triggers are removed. If necessary, some antiepileptic drugs can be tested for drug concentration first, and if the drug concentration is low, the dosage can be adjusted under the guidance of the doctor.  2. Is it necessary to monitor the blood drug concentration during medication administration?  A: Through the determination of drug concentration in blood, clinicians can adjust the drug dose and individualize drug therapy according to the individual patient’s condition using the principles and methods of pharmacokinetics. Moreover, the child’s weight is constantly changing during the development process, and drug concentration monitoring is appropriately performed. This not only improves the drug treatment effect, but also avoids or reduces the possible adverse drug reactions.  3.If the blood drug concentration always fails to reach the standard, is it necessary to increase the drug dosage?  A: Generally speaking, blood concentration and drug dose are correlated. If the blood concentration does not reach the standard after examination, the dose can be increased slowly until the attack is controlled or the maximum tolerable dose. In children, the dose is calculated according to body weight, but the maximum dose should not exceed the adult dose. Patients who experience dose-related adverse reactions (such as dizziness, drowsiness, fatigue, ataxia, etc.) during treatment can temporarily stop increasing the dose or reduce the current dosage as appropriate, and then continue to increase the amount to the target dose after the adverse reactions subside.  4.If the blood concentration has reached the standard, but there are still seizures, is it necessary to change the medication?  A: The effective concentration of antiepileptic drugs is a range. If the blood concentration has reached the standard but there are still seizures, you can continue to adjust the drug to the maximum tolerable dose according to the child’s condition and closely monitor the drug concentration and liver and kidney function, blood routine, etc.; for the first drug to reach the maximum tolerable dose and still have seizures, you should try another drug and increase the dose to a sufficient dose and then slowly The dose of the first drug should be slowly reduced.  In addition to testing blood levels, what other tests should be done during drug administration?  A: Different antiepileptic drugs have different effects on the body. Depending on the specific antiepileptic drug used, in addition to regular testing of drug concentrations, routine blood tests, liver function, electrolytes and other related tests should be performed.  6.Can I get vaccines and flu vaccine during the medication period?  A: It is mainly based on the cause of the child’s epilepsy. For seizures caused by immune reasons, vaccination is not recommended during medication; for other causes of epilepsy, vaccination can be given after at least six months of seizure control.  7. Some children are prone to colds, can they take cold medicine while taking antiepileptic drugs?  A: You can take cold medicine normally while taking antiepileptic drugs.  8.If my child needs to take antibiotics or other drugs, do I need to stop taking antiepileptic drugs?  A: Anti-epileptic drugs need to maintain a certain blood concentration in order to work consistently and steadily, so you cannot stop/reduce the dosage of anti-epileptic drugs until your doctor has assessed and told you that you can start to reduce the dosage.