What happens if you miss a dose of seizure medication?

  • May 17, 2023
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Have you ever realized you’ve missed a dose of seizure medication? Forgetting to take epilepsy drugs is easy to do - maybe you were traveling, or you ran out of your meds. In one recent survey of people with epilepsy, 71% said they’d forgotten to take their dose at some point. 

Oftentimes, missing one dose of seizure medication isn’t a major problem - there are simple solutions we’ll explore in this article. But it’s important to be aware that forgetting a dose could make having a seizure more likely. In fact, this is one of the top causes of breakthrough seizures. 

So, what happens if you miss a dose of seizure medication, and how can you avoid this in future?

Breakthrough: Coping after a breakthrough seizure

Here’s what happens if you miss a dose of seizure medication

To understand what happens if you miss a dose of seizure medication, it’s helpful to take another look at how anti-epilepsy drugs work. At a basic level, seizure medication works in one of two ways:

1. Decreasing ‘excitation’ (the electrical activity) in your brain

2. Slowing down or stopping how electricity gets sent around your brain

Now, if you forget a dose of your anti-epilepsy drugs, then your brain cells are likely to become much more active, leading to a seizure. And because this change happens quite suddenly, it could also increase your risk of serious seizures - including long ‘status epilepticus’.

What to do if you missed one dose of seizure medication 

If you’ve just missed one dose of your seizure medication, don’t panic. Although breakthrough seizures are possible after missing a single dose, it’s relatively uncommon. The risk is higher if you forget to take more than one dose.  

Below are some suggestions of what to do if you missed one dose of seizure medication. 

Remember that everyone is different - you might take multiple doses per day, or just one. Your pills might be ‘stronger’ (contain more active ingredients) than other people’s. Your size, sex, age and other physical activities all come into play. The following tips are only general - they don’t apply to everyone. It’s always best to speak directly with your treatment team for advice personalized to you.

  • Don’t double dose

You might be tempted to double up on your meds next time you take them to make up for the missed dose. This isn’t necessary, and could cause unpleasant side effects. Read more in our blog about double dosing

  • Read the patient leaflet

All seizure medication will contain a leaflet that should provide information on what to do if you forget a dose. Of course, many people throw this leaflet away when they discard packaging - especially if they've been taking seizure drugs for years. But if you have access to the leaflet, follow the manufacturer’s advice. 

  • If you take ONE DOSE per day

Your treatment plan will usually include a certain time for taking your medication - this is intended to make the drugs most effective. But if you realize you forgot a few hours later, simply take the meds as soon as possible, then continue as usual the next day. It’s best not to simply skip the whole day, because the level of medication in your body could become too low, risking a breakthrough seizure. 

  • If you take TWO DOSES per day

If you missed one dose of seizure medication, but it’s more than 6 hours until your next dose, then take the missed dose now. If your second dose is timed to happen within 6 hours from now, just carry on as usual. 

  • If you take THREE OR MORE doses per day

It’s generally OK to simply wait until your next dose and carry on as usual. 

Polytherapy: Taking multiple medications if you have seizures

Tips for remembering to take seizure medication

It’s totally normal to forget to take seizure medication from time to time - we’ve all got busy lives and so taking pills, syrups or powders can easily slip your mind. While occasionally  missing one dose of seizure medication is easy to do, try your best to avoid this, since breakthrough seizures can happen. 

Here are some ways to reduce your chances of forgetting to take your medication:

1. Use Epsy

Epsy is an easy to use app which lets you set reminders to take your medication. You can also use it to log when you’ve taken your seizure meds, so you can always double check if you’re unsure about whether you took them or not. And it can really help with reminding you to take your AED - in a 2022 survey, 94.8% of Epsy users said it helped with their medication compliance. 

2. Make sure you have enough seizure medication

Try to stay on top of your supply of medication, visiting your pharmacist regularly to ‘top up’. 

3. Use a weekly pill box (if you take medication in this form)

A weekly pill box lets you put your seizure meds into daily compartments. You can then easily see which day it is, how many you’ve taken, and see if you’ve forgotten any. 

Alternatively, if you take your meds as a powder or syrup, you could print out a timetable and put it on your fridge or somewhere you’ll easily see at home as a reminder. 

4. Talk to your treatment team

If you’re finding it hard to follow your medication schedule for any reason, talk to your doctor. There might be other ways of taking your medication that you might find easier (e.g., replacing pills with a syrup, or powders you can mix into your food). 

If you have epilepsy, it’s important to know what happens if you miss a dose of seizure medication. While missing a single dose is usually OK, being prepared - and making an effort not to forget in future - will reduce your risk of breakthrough seizures

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