Epilepsy – living with it and taking your medicine
What epilepsy is, why never missing a dose matters more here than almost anywhere, driving and safety rules, and what to do when someone has a seizure.
What epilepsy is
Epilepsy is a condition in which someone has repeated seizures caused by bursts of abnormal electrical activity in the brain. Seizures look different from person to person: some involve the whole body stiffening and jerking, others are brief lapses of awareness, unusual sensations, or repeated movements the person is not aware of.
It is common, it is treatable, and most people who take treatment consistently have far fewer seizures or none at all. It is not contagious, it is not caused by witchcraft or by anything the person did, and it is not a mental illness — misconceptions that still cost South Africans jobs, schooling and relationships.
Why adherence matters more here
- Take it at the same times every day. A reminder is not a nicety in epilepsy.
- Never stop suddenly, even if you have had no seizures for years. Stopping abruptly can cause severe, prolonged seizures. Any change is planned with your clinician and tapered.
- Collect the repeat before you run out, not on the last day. Plan around long weekends and clinic closures.
- Illness, vomiting, poor sleep, alcohol and some other medicines all raise the risk. If you vomit shortly after a dose, ask a pharmacist what to do rather than guessing.
Medicines used for epilepsy in South Africa. Which one suits a person depends on their seizure type, other conditions and other medicines:
Carbamazepine — Tegretol, Tegretol CR, Carbagen, Epitol
Epilepsy (focal and generalised tonic-clonic); trigeminal neuralgia; bipolar disorder
Sodium Valproate / Valproic Acid — Epilim, Convulex, Depakote, Depakene
Epilepsy (generalised and focal); bipolar disorder; migraine prophylaxis
Lamotrigine — Lamictin, Epitec, Lamotrin, Elmendos
Epilepsy (focal and generalised); bipolar disorder (maintenance — depression prevention)
Levetiracetam — Keppra, Levroxa
Focal and generalised epilepsy (monotherapy and add-on); status epilepticus (IV)
Phenytoin — Epanutin, Dilantin
Epilepsy (focal and generalised tonic-clonic); status epilepticus (IV)
Pregnancy, contraception and other medicines
Folate supplementation is often advised for women with epilepsy who could become pregnant. folic acid (Folic Acid Lennon) is inexpensive and available at clinics; ask what dose applies to you, as it may be higher than a standard pregnancy dose.
- Epilepsy medicines interact with many other medicines, including some HIV treatment, some TB treatment, some antibiotics and some antifungals.
- Tell every prescriber and every pharmacist that you take an epilepsy medicine, every time.
- Traditional medicines can interact too. Mention them.
Safety, driving and daily life
- Driving is regulated. South African law places conditions on driving with epilepsy, and it is your responsibility to declare it and follow your clinician's advice. Ask specifically rather than assuming.
- Showers are safer than baths. Drowning is a real risk during a seizure, even in shallow water.
- Tell a few people what to do — colleagues, classmates, family. A seizure is far less dangerous when someone nearby is not panicking.
- Keep a simple record of when seizures happen and what came before. Patterns matter to the clinician and are easy to forget.
Common questions
- What happens if I miss a dose of my epilepsy medicine?
- A missed dose can trigger a seizure the same day, because these medicines work by keeping a steady blood level. Take it as soon as you remember unless it is nearly time for the next one, and ask a pharmacist rather than doubling up.
- Can I stop epilepsy medicine if I have had no seizures for years?
- Never on your own. Stopping abruptly can cause severe, prolonged seizures. If you and your clinician decide to try, it is done as a slow planned taper under supervision.
- Can I drive with epilepsy in South Africa?
- There are legal conditions on driving with epilepsy, and it must be declared. Ask your clinician what applies to your situation rather than assuming, because it depends on seizure control.
Sources
- Adult Hospital Level Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Medicines Online Directory and approved patient information leafletsSouth African Health Products Regulatory Authority
- Clinical and public health guidanceWorld Health Organization
Last reviewed 11 August 2026.