Hi Everybody - I am from India

[raghavan]

Hi Everybody,
I am from Chennai (Formerly Madras) in India. I suffer from Mesial temporal lobe epilepsy for which I am taking oxcarbazepine and clonazepam for the past one year but with not much improvements. I am thinking of asking my doctor to add some new medicines to the existing ones that I am taking. Which one is the best (Levetiracetam ?) Can someone suggest a list of medicines which I can discuss with my neurologist and try under his supervision ? Thanks
Regards
Raghavan

[speber]

We're not really doctors here and shouldn't claim to know what's 'best'...especially without knowing exactly what your situation is.
However, there are several threads on anti-epileptic drug's(anti-epileptic drugs) including their side effects.
There are also threads on ALTERNATIVE treatments and therapies!
Please do some searching on this forum!
I am in a rush this morning or would post you some links!

Peace
Spencer

[RobinN]

Hi Raghaven - Welcome to CWE.

It has been my understanding that monotherapy is the best route to take, when looking for an anti-epileptic drug to control seizures (at least at first).

"Because coadministered drugs are subject to drug interactions, add-on trials of anti-epileptic drugs do not necessarily address the utility of a new anti-epileptic drug as monotherapy or its use in patients with newly diagnosed epilepsy, in whom monotherapy is usually sufficient. Monotherapy clinical trials are difficult to design because randomizing epilepsy patients to placebo or pseudoplacebo is considered unethical, and results from active-drug noninferiority designs are difficult to interpret. Active-drug superiority designs have been developed in an attempt to provide useful information about the monotherapeutic efficacy of new anti-epileptic drugs. The conversion to monotherapy trial design, introduced in the late 1970s, provides for initial add-on of an investigational agent to a preexisting drug in patients with uncontrolled seizures, followed by gradual discontinuation of the preexisting treatment and an eventual monotherapy phase of the investigational agent. Conversion to monotherapy trials are typically of short duration and have been criticized for failing to provide adequate time for titration to optimal dose, an inability to examine tolerance development or long-term safety, and possibly placing enrolled patients at increased risk for morbidity, but they have been used to obtain data about monotherapy efficacy sufficient for regulatory authority approval. Relevant clinical trial data are needed to guide treatment choices in patients who have failed previous monotherapy. To date, large-scale prospective trials comparing monotherapy with old and new anti-epileptic drugs have not shown superior efficacy of the new anti-epileptic drugs but have demonstrated their better tolerability and safety," wrote R. Sachdeo and colleagues.

http://professionals.epilepsy.com/ne...203085841.html

[Bernard]

Hi Raghavan, welcome to the forum.

I don't know about the "best" treatment(s) for it, but you might find this interesting:

Human Herpesvirus-6B with Mesial Temporal Lobe Epilepsy

[skillefer]

Welcome Raghavan!

[Birdbomb]

Welcome Raghavan

You'll find plenty of comparisons of medication and how some people react.

[Stacy]

Hello Raghaven and Welcome!

I'm not a Dr., but I sure have gone through it. My best suggestion to you is to keep a journal / log of EVERYTHING you do for about 4-6 weeks. When I say everything, I mean every action from the time you get up to the time you go to bed.

Example.... 4/28/02
6AM - Wake up, pills, feel ok (dizzy, etc),
6:15 - wake kids up, Go to restroom (what it looked like....), yoga
6:45 - get kids to bus
7:00 - breakfast.... eggs, muffin, read paper, Dilantin100mg, feeling GREAT (or not)
8-00 - laundry
etc.....

This is very tedious, however, it really helps create a pattern for your seizures, which you will be able to discuss with your Dr. and even find root causes that weren't there before...or that you didn't think of. The Dr's are all very smart, and they don't always realize there are alternate causes as well as treatments. With this journal, you will be able to show them what is happening in your life. Good luck.

[raghavan]

Thank you everybody for the overwhelming response and support. The reason why I asked about Levetiracetam was it acts differently from older anti-epileptic drug as many of you here will know. It acts on a protein in the Synaptic vescicle (I don't remember the name of the protein) and it has no action on the sodium pathway. So it is supposed to be a good adjunct therapy for refractory epilepsy. But unfortunately I am not able to get much material on Levetiracetam's effectiveness in controlling mesial temporal lobe epilepsy. So all of you who are taking medicines for MTLE can please list the medicines that you find effective for MTLE I will get a better idea. But I will never do self medication. You don't have to worry about that. I discuss a lot of technical issues about epilepsy medicines and their mode of action with my neurologist who belongs to the modern era and I interact with him regularly through email as well as personal consultation. Anyway thanks for the overwhelming support. I really appreciate that. Please keep posting your experiences on the treatments that you are taking and the medications in this thread. Thanks again.

Regards
Raghavan

[brain]

Raghaven!

Welcome to CWE! Levetiracetam is known
here as Keppra, and unfortunately Keppra
does not agree with me at all, I had to be
taken off of it and I wasn't on that drug
very long at all!

HOWEVER - this drug is considered a
wonder drug to half of the population and
a nightmare to the other half of the
population. It can work FOR you or it can
work AGAINST you. I hope it all
works FOR YOU!

Feel free to browse around the CWE!

[raghavan]

Thanks Brain,
I also heard about what you said. It either completely controls or aggravates. Maybe that is the reason my neurologist has not prescribed it in my case. But my friend and school mate who is a neurologist in a hospital in Manchester said in UK they use Levetiracetam as the first line drug for a wide range of epilepsies and that they don't prescribe Oxcarbazepine much.

[RobinN]

Are alternatives ever suggested to you? Or is it only drug centered therapies?

I should have included in my above post:

Several uncontrolled trials have shown that anti-epileptic drug monotherapy is equally or more effective than polytherapy in the treatment of both adults and children with epilepsy
Monotherapy is the preferred treatment for patients with epilepsy.

http://www.cmediscovery.com/monotherapy/program.html

Preferred was the word ... not best.

[raghavan]

Hi Robin,
No alternatives have been suggested to me. What are they ? The link you gave was very useful. Thanks

[Bernard]

Check out my signature for information on alternatives.

[BuckeyeFan]

Welcome to our group. It seems to me that the majority of members are from the USA, but there are also members from Australia and Europe.

Please stay and be a part of our group. Epilepsy impacts all of us no matter what man made categories we use to define the world.

Have a cup of coffee on me.