How long to get rid of kindling and get control on a new med?

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kirsten

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I started my new med a few months ago I think. I went to the neuro last week and I thought he was going to put me directly on the full dosage of the new AED, after which I intended to switch to an epileptologist. But he's added only 600mg to my daily dosage and told me to come back to continue increasing in six months time. I could get used to a doctor doing this slowly, to wait for kindling to go away before deciding whether a medication needs to increase, but six months seems excessive to me.

I am impatient now because last week I saw my psychiatrist and I wrote about it here. I wasn't happy with some of the things she said and some of the things she didn't do, and I was going to tell her in the next session what I was unhappy about because if I've learned anything in therapy it's that I must not run away from issues but confront them. I have the session coming up this coming Tuesday but I've already forgotten the last session which I wanted to discuss with her. I did have another TC in the last couple of days and I guess I just lost the memory of the session. I can refer back to the post I wrote here but it isn't enough. I need to remember the entire session to confront it properly.

It's also taking me so much time to do work that would have taken me a short while to finish before, and I never really know whether the work I produce is going to be up to standard, so I always feel unsure about taking work from clients I value. I wrote for a client yesterday and when I sent it I felt really good about what I had written. But I went back to read it today and it's actually not very good at all. She's my favourite client and I don't want to lose her. Things like this make my life difficult to manage properly and I can't keep on living like this for an entire six months on top of the last six months. That is an entire year lost to me, and I already feel I have lost too much time.

How long does kindling last and how do we know that what I'm experiencing is kindling or just the medication not working? How long does it usually take you to change meds? In the past, it's only taken a month to move to a new med, so this new way is weird to me.
 
When I've changed meds, the time I was on it has varied, depending on the medication. For some meds, the time frame probably would depend on the 1/2 life of each med and the steady state of the medication. Usually it takes several months to see whether the med is working or not.
 
the only full change I've had is change from Dilantin to Lamictal which was wonderful as the former was a horrible feeling for me. Since all they've done is increased the dose for the following sz, then add Keppra plus increase Lamictal at second. Still haven't heard results from this week's EEG so not sure what the next step will be. Don't really want to change, at least the Lamictal part as that has seemed to mostly work.
 
It's the Neurontin that we're titrating. It has a short half life but I don't know how long it takes to reach stable levels. I've been on every other med except the two brand new ones, and we've always changed in a month, maximum two months. I've never been on the full dosage of Neurontin but the neuro tells me that 3600 is the therapeutic dosage for TCs. He's taken me up to 1800, which means I'm not on the therapeutic dosage, so I fail to understand how it is okay that I should be having seizures for six months more when there might be something we could do about it. I wish I'd known he only wanted to go up again in 6 months when I was at the appointment. Then we could have discussed it properly. Or maybe he's just not really trying with the Neurontin because he wants to do the VNS in Jan. I don't know.
 
I wish I could remember my titration rate when I took Neurontin many moons ago. I wasn't on it for long, maybe a year or 18 months. But it didn't do a thing for my TCs. I don't understand your docs thinking, either. Can you send him an email or something?
 
I spoke to the sister the day before yesterday and she's the one who told me I had to stay on the current dose for six months, so I've questioned her and asked her to confirm that directly with the neuro because I'm struggling to believe it.
 
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