Regimens for initial dosing tend to vary with different drugs. In general, drugs are started in a small dose and increased at two-weekly intervals to the minimum effective dose. The patient's seizures are then monitored and further increases in dose only made if seizures continue. The time interval for dosage increases should therefore be sufficiently wide apart to allow changes in the seizure frequency due to changes in drug therapy to be accurately determined. These issues are particularly important for a doctor, e.g. in an emergency department, who has never seen the patient with a fit or series of fits. It is important then to consider the cause, whether it is noncompliance (which can be due to intercurrent disease), an inadequate drug regimen or an increase in the severity of the disease.

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