Question
How to handle the situation of reduced efficacy or increased side effects of anti-epileptic medications? Should one consider readjusting the dose or switching medications?
Answer
When considering adjusting the dose of anti-epileptic medication or switching medications, the following principles can be followed:
- If the original medication has been effective, individualized dose adjustments can be made by measuring the drug concentration in the blood.
- If the original medication is ineffective or has significant side effects, when switching to a new medication, it should be given time to stabilize and for seizures to be controlled before gradually discontinuing the old medication.
- If multiple medications are being used in combination therapy, when discontinuing old medications, only one medication should be stopped at a time, with at least one month between each discontinuation. If no seizures occur during this period, the next medication can be started to be discontinued.