Lamictal worked for a couple weeks, now worse than before...

[violetopia]

Hi folks,

I have partial seizures & a med question. A few weeks ago I started Lamictal while also slowly tapering off Depakote. The first 2 1/2 weeks I saw fantastic results. I went from 4-5 seizures a day to 1-2. And I started having fewer complex seizures than before, more simple ones instead.

I was very pleased because Depakote had done nothing for me, and I felt less mentally fuzzy on Lamictal as well. But a week ago, everything went wonky with the Lamictal. I went from 50 mg to 75 and a couple days later, my seizures zipped back up to 4-6. Yesterday I had 7, which is the most I've ever had in 1 day.

I've had minor stress the past week from the holidays and a short car trip, but there was far more stress the week before: I had a terrible cold and also got married on the 18th! So as far as I can tell, stress is not a big factor at the moment.

Today my Lamictal dose went up to 100. I know this is still a very low dose and these things take time. What I'm wondering is this: Is it common to see improvement on a drug for a couple weeks, then backslide or even have more seizures than before? Could the improvement have been a placebo effect? It's too soon to give up on Lamictal, right? Thanks for your input, and happy holidays to all!

[Endless]

Hi, Violetopia,

Welcome to the forum! LOVE your fractal!

I'm on Lamictal, too. It's a tricky little drug. I've been living with some yucky side effects, including insomnia (only 2-4 hours of sleep a night) and dizziness. But I have to love the way it doesn't put fuzz in my brain. I can actually think on this stuff, (if it wasn't for the sleep deprivation).

It may be a good idea to call your doctor right away and let him know you are experiencing an increase in seizures.

It could be the Lamictal - an increase of seizures can be a side effect of Lamictal.

Seek medical attention right away if any of these SEVERE side effects occur when using Lamictal:
...new or worsening seizures...

http://www.drugs.com/sfx/lamictal-side-effects.html

100mg is a teeny tiny dose - even smaller than they give most kids. Some people get seizure control on that dose, but not many. It's entirely possible to "get used" to a dosage and need to increase it. Or, it could be random variation in your seizure frequency. Once in awhile I go a whole month without seizures, then bam! Back to 3-5 a day.

It could also have been the stress. Sometimes the effects of that can hit a week or two later.

It couldn't be the Depakote finally being out of your system. The half life of Depakote is 6-17 hours, which means it's pretty much out of your system within 4-5 days.
http://www.epilepsyfoundation.org/an...e/depakote.cfm

Be patient with the Lamictal. You need to ramp up very slowly to avoid the adverse reactions, including the infamous "Lamictal Rash." Your neurologist will keep you increasing until the seizures are under control. Thing is, sometimes as you increase the dosage the side effects increase, too. Be sure to call your neurologist and tell him when any of those kick in. Some (like diziness) are dose related. If they back off on the dose for awhile, the side effect gets better, too. Then after your body has had more time to adjust, the dose can be increased again.

Do you keep a seizure diary? It helps track and find patterns in possible seizure triggers, seizures, after-effects, etc. Here's a string on the different seizure diary formats. It's easier to use one that's already put together.
Seizure Journals

Hang in there.

[violetopia]

Thanks, Endless, for your good advice. I ended up calling yesterday and then seeing my neurologist today. (They fit me in awfully fast when I said I'd had 11 seizures yesterday...) To my surprise, the neurologist is not changing my meds. We will keep on titrating the Lamictal until I get to 200 mg, unless the seizures get worse. His thinking is that since it worked well for a couple weeks, it's worth it to give it a full chance. Then we can see about changes as needed.

I guess I'm good with that. The side effects of this drug have so far been minimal for me. I trust my neurologist, and he really listens to me. So I'll take his advice and keep hanging in there.

Seizure journal: I do keep one, but it's just a spreadsheet. I'll look at the link you posted and see if it would work better. (Probably would.) Thanks again.