For people with epilepsy and their loved ones, staying on schedule with medication is key for preventing seizures. But sometimes an epilepsy treatment schedule may need to be adjusted due to a time change or travel.

One MyEpilepsyTeam member asked about their medication time. “I’ve heard different opinions, and I’m about to email my neurologist. But I’m curious what you all do! Start taking it an hour before so it’s accurate with what the normal time would be, or keep it where it’s at?”

Your neurologist can advise you on the best ways to stay on schedule with your or your child’s particular treatment plan during a time change. Here are some rules you can discuss further with your doctor about adjusting medication for a different time zone.

Why It’s Essential To Stay on Schedule With Epilepsy Treatment

Epilepsy medication needs to be taken on a regular schedule to be as effective as possible in preventing breakthrough seizures — seizures that happen after epilepsy has been controlled with medication for a period of time.

Finding the right medication, dose, and schedule may take some trial and error. Your healthcare team can help you find a routine that works best for you.

Taking medication as prescribed is important for seizure control. In one study of 108 children with epilepsy, 34 percent had breakthrough seizures linked to not taking their medication as prescribed. Only infections with fever were reported more often as a trigger.

Missing Even One Dose Matters

Missing a dose isn’t the same as a planned, clinician-approved time adjustment. A missed dose is unplanned or even an accident. A planned adjustment is meant to keep your medication schedule steady while accounting for a clock change, travel, or a dosing-time problem.

Missing seizure medicine can trigger seizures in people with well-controlled or poorly controlled epilepsy. Missing one dose may not always cause a problem, but the chance of having a seizure may be higher, especially for people who take medication once a day.

In severe cases, missed medicines can lead to longer seizures called status epilepticus, which is a medical emergency. Don’t stop, skip, or change seizure medication without talking with your healthcare provider first.

Best Time To Take Seizure Medication

There is no universal best time to take seizure medications. The right medication time depends on the prescribed medication, dose, dosing schedule, formulation, side effects, and individual seizure pattern.

For some people, the best time is simply the time they can follow consistently every day. If your medication instructions are confusing or hard to follow, ask questions until you’re sure you understand them.

Taking the same dose twice a day may make it easier to follow a regular medication routine. People who take medicine three or more times a day, or who take different doses throughout the day, may need extra planning when their schedule changes.

Adjusting for Travel and Time Zones

Travel across time zones can affect medication timing, especially when the new local time makes your usual dosing schedule hard to follow. Before crossing time zones, talk with your doctor or nurse about how to manage your meds.

The goal isn’t simply to take medicine at the same clock time wherever you are. The Centers for Disease Control and Prevention (CDC) notes that medication timing may need to be based on elapsed time, not only the local time of day.

Your doctor may advise a gradual change to your medication schedule before your trip or during the first few days at your destination. This can help if your usual medication time would fall in the middle of the night in the new time zone.

What To Do if You Miss a Dose

Ask your doctor, nurse, or pharmacist in advance what to do if you miss a dose. The answer depends on the specific medication and how often you take it.

Some missed doses can be made up if you remember within a certain period of time, but taking too much at once can be unsafe. Go over your medication list with your healthcare team and ask for specific instructions on when to make up missed doses.

If you miss a dose, try not to panic. Use the instructions your healthcare team gave you, and call your doctor or pharmacist if you’re unsure what to do. If you have a seizure emergency, use your seizure action plan and get emergency help when needed.

Plan Ahead and Take Precautions With Time Changes

If you or your child will be traveling to another time zone, talk to your healthcare team as early as possible. The CDC recommends that travelers with chronic conditions prepare four to six weeks before travel and discuss when to take medications if travel involves time-zone changes.

Medication-focused travel tips include:

• Talk to your doctor about your destination, time-zone changes, and seizure history.
• Pack enough medicine for the full trip, plus extra in case travel is delayed.
• Carry medication in your hand luggage instead of checked baggage.
• Keep medicines in properly labeled bottles.
• Bring rescue medication if it’s part of your treatment plan.
• Write down medication instructions or bring a medication schedule.
• Set alarms, use a pillbox, or check off doses on a chart or seizure calendar.

Jet Lag and Sleep Deprivation May Trigger Seizures

Long flights across multiple time zones can cause jet lag, a temporary sleep problem that happens when your usual daily rhythms don’t match a new time zone. Jet lag can affect mood, concentration, and physical and mental performance.

“Thinking of traveling overseas soon, and my kids have epilepsy. Since they’re triggered by sleep deprivation, I’m worried that the travel will exhaust them. The travel time is like 20 hours,” a MyEpilepsyTeam member wrote.

Adjusting your sleep cycle a few days before travel may help you adapt more quickly to your destination. The CDC recommends going to bed an hour or two later than usual when traveling west and an hour or two earlier than usual when traveling east.

Once you’re in a new time zone, small meals, plenty of water, and short naps of no more than 15 to 20 minutes may help with jet lag symptoms. Avoid alcohol because it can disrupt sleep.