Depakote ---> Keppra, going good but question

[darcness]

Well my wife is now on the road to weaning off Depakote and being put on Keppra. She's already titrated up on the Keppra to 1000mg which was uneventful sans one strange episode when I'm pretty sure she forgot to take her meds all together one night.

Her neurologist titrated her up on the Keppra by going 250AM/250PM for 3 days, then 250/250/250 for 3 days, and finally 500AM/500PM for the remainder. So that all went pretty well.

For the Depakote she is doing a month long taper, also recommended by her neurologist. She was on 500AM/500PM and now she is on 500 in the morning only for a month, then cutting it all together after that.

Since she stopped taking the Depakote at night I've noticed that she's sleeping better, she's been getting out of the house more, and overall just seems more like herself. I've also noticed that the night time muscle jerks are much, much better. In fact, I think they may be completely gone now that she's been on the lower dose of Depakote.

The only real problem right now is that she's having a bit of anxiety the last few days. Has anyone else experienced a rise in anxiety coming off a certain anti-epileptic drug?

I know Keppra is known for some mood changes, but I haven't noticed the feared one (Kepprage). However, could the anxiety be caused by the Keppra?

Just curious if it's a withdraw related thing or a SE of Keppra...

[dfwtexas]

I am a Keppra person. I have never been on any other seizure meds. I do have to say I was pretty anxious when I started keppra, but I chalked it up to learning and dealing with the E diagnosis.
I am glad you are seeing improvements. When I first got diagnosed and neurologist put me on Keppra....I researched it (my father had taken tegretol and dialintin for seizures and knew he hated side effects) and was pleased to read so much positives...both about side effects and improvement in seizures.
I take 1000 mg twice a day. I had started 500 mg twice a day, but had a few breakthoughs and got my levels upped.
It is so refreshing to see a spouse being so pro-active about care.
jenn

[Meetz1064]

will say that I experience anxiety EVERY time I go ONTO a new anti-epileptic drug, and EVERY time I come off of one, too. It's the fear of the unknown....Will I have a seizure? What's the med going to be like? Am I going to be able to function? Are there going to be any weird side effects that I have to deal with? Yadda yadda yadda.....I think you get the idea.

As for dealing with Kepprage, you can combat that with Vitamin B6. Better yet, take a B complex vitamin every day. The B vitamins are great for brain health.

[darcness]

Thanks to both you!

I'll definitely make a suggestion that she tries Vitamin B complex daily. She now calls me Dr. Ron on a regular basis.

I love my wife, and I'm glad we can joke with each other about all of this now. There was a time I never thought that day would come.

I'm not sure what the anxiety is all about, but perhaps the Vitamin B can help with that too, if it is in fact caused by the Keppra.

[epileric]

I'm not sure what the anxiety is all about, but perhaps the Vitamin B can help with that too, if it is in fact caused by the Keppra.

One thing my seizures do is effect my mood. I know when I was younger I'd be in a great mood & about to do something with friends when suddenly I'd feel either depressed, paranoid, or just anxious about everything & anything (or of course any combination of those moods).

Just be aware that ones moods can be effected by seizures but even if they are, it isn't necessarily going to happen every seizure.

[darcness]

Oh trust me Eric, I know her seizures affect her moods. She had some MAJOR phychosis going on during her first partial. She was so bad that first the EMT's and cops thought she was on drugs, then the police officer told me she had some serious "emotional" issues going on.

I was like, hey thanks captain obvious. Fortunately that hasn't happened since that first partial. Even after her t-c's she still has been rather emotional though, but the post-ictal phase was much shorter for those.

I think the anxiety is just a combo of coming off the Depakote and perhaps a start up side effect of Keppra.

She's always had some issues with anxiety, and is on Lexapro for it. It usually does a really good job of keeping things on an even keel for her. She has Xanax that she uses PRN as well so it really hasn't been that much of a problem.

[Billyboyboo]

I take Keppra 260mg/250mg, but also Klonopin, which is a Anti-Anxiety to my knowledge, I do have anxiety still sometimes.

[darcness]

I take Keppra 260mg/250mg, but also Klonopin, which is a Anti-Anxiety to my knowledge, I do have anxiety still sometimes.

Yep, Klonopin is an anti-anxiety medication in the same family as Xanax. It's usually given to people with E because it can help to control seizures as well as alleviate stress/anxiety related to or caused by the E. Klonopin is longer lasting then Xanax but doesn't work as quickly.

[cr8tiv1]

My husband was seizure free for 30 years with Dilantin and Depakote. In an effort to mitigate the side effects of these drugs, his Dr put him on a regime that would wean him off the old drugs and take only keppra. He weaned off the Depakote fine but when he tried to get rid of the Dilantin completely his seizures returned. He stabalized on Keppra and Dilantin...BUT he became terribly depressed, angry and detached. His deep depression almost destroyed our marriage. Sooooo-new neurologist put him on a regime of weaning off the Keppra and taking Topamax. He took his last Keppra about 24 hours ago and had a seizure at 3am and another at 11:15am today. He's never had 2 seizures in a row and never a seizure during the day (although he was sleeping when it happened). All this is to say, Keppra can wreak havoc emotionally and I wonder if anyone else out there our their loved ones have experienced something similar when getting off Keppra?

[Crystal11]

I take Keppra XR 3000mg, Tegretol XR 400mg and now Lamictal 200mg each day. I think that Keppra makes people sleepy the first week or two, then it goes away. But the anxiety can also be something simple from changing out a med- and knowing that you depend on the new one and one existing one, or her body really wanting more of the other med- or just plan anxiety she feels from her new physical improvement..
Not real sure which- but you might ask her neurologist if the anxiety is Keppra related or a med change anxiousness or whatnot.
You are a great person for being there for her when she goes through things.
Many people are often left alone or don't live with someone.
I live with my twin sis and best friend and we all three have Epilepsy. Boy it can be nerve-racking to constantly be checking up on eachother or making sure everyone has taken meds etc. But we all love eachother as family and want to do our best to care for eachother.


Take care,
Crystal