PROTOCOL

1
Provide psychoeducation to the person and carers (2.1)

Initiate antiepileptic medications (2.3)

Promote functioning in daily activities (2.2)

Special populations
Note that interventions are different for EPILEPSY in these populations

HIV

WOMAN OF CHILDBEARING AGE CHILD / ADOLESCENT PERSON LIVING WITH HIV

Concern: Risk of antiepileptic medication to fetus/child Concern: Effect of antiepileptic medication Concern: Drug interactions between antiepileptic
on development and/or behavior medications and antiretrovirals

Advise folate (5 mg/day) to prevent neural tube For those with a developmental disorder, When available, refer to specific drug interactions
defects, in ALL women of childbearing age. manage the condition. Go to CMH. for person’s antiretroviral regimen and antiepileptic
medication.
AVOID VALPROATE. For children with behavioural disorder, avoid
phenobarbital if possible. Manage the condition. Valproate is preferred due to fewer drug-drug
CAUTION If Pregnant:
Go to CMH. interactions.
– Avoid polytherapy. Multiple medications in combination
increase the risk of teratogenic effects during pregnancy. AVOID PHENYTOIN AND CARBAMAZEPINE
– If medications are stopped during pregnancy, WHEN POSSIBLE.
they should always be tapered.
– Advise delivery in hospital.
– At delivery, give 1 mg vitamin K i.m. to the newborn
to prevent haemorrhagic disease.

If breastfeeding, carbamazepine preferred to other

medication.

EPILEPSY 63