Med change, six week apt

[Redsaber]

Went to my neurologist yesterday. He actually listened some what tos time. He's weaning me off Keppra totally in a week. From 1000 a day, then this week 500 a day then after 7 days no more Keppra. And just 200 of the lamictal. Any thoughts on this? Just wondering if this sounds like a good idea?

[Endless]

Well, good riddance to keppra. Lots of people get along on it just fine, but I wasn't one of them. You, either, if I remember correctly. I don't know about the speed he's taking you off the stuff. I like to go off things more slowly, but that might just be me. My body is really sensitive to changes.

200mg of Lamictal isn't much. Is he planning on increasing your dosage at all? Your next appt is 6 weeks out? Please be sure to call him if your seizure activity increases. You'll need to get that nipped in the bud FAST.

[Nakamova]

The 200mg Lamictal might be okay -- I'm at 175mg/day, and the World Health Organization guidelines recommend 100mg to 200mg/day for Lamictal monotherapy --but as Endless says, if you feel funky in any way call your doc right away.

[Endless]

Hi, Nak,

I'm having a little trouble finding the WHO guidelines. I'd like to show them to my doc. Can you find a link?

Addendum:

Aha! Found a link on the WHO website on epilepsy treatment. It includes several studies on different anti-epileptic drug's, their costs, and effectiveness. There weren't any WHO guidelines on dosages, per se, but the studies did have dosage ranges from 25 to 450 mg. Most were in the 100-200 range.

http://www.who.int/selection_medicin..._inclusion.pdf

[Nakamova]

I think the file i have is the same file you found:
http://who.int/selection_medicines/c..._inclusion.pdf

On page 14, it lists dosage recommendations (taken from "Martindale: The Complete Drug Reference, 35th Edition, by Sean Sweetman):

Adults: Dose for use as monotherapy is 25 mg once daily by mouth for 2 weeks followed by 50 mg once daily for 2 weeks; thereafter the dose is increased by a maximum of 50 to 100 mg every 1 to 2 weeks to usual maintenance doses of 100 to 200 mg daily, given as a single dose or in 2 divided doses. Some patients have required up to 500 mg daily.

I also remember an Italian study that recommended the same 100 to 200 mg range (although I'd have to dig it up). Of course the main thing to remember is that there is no established a therapeutic blood plasma range for Lamictal. The dosing of lamictal is based on therapeutic response, which is different for everyone. In other words, whatever works, works.

[momof3boys]

My dr is weaning me off the Keppra too... Only right now Im taking 3000mgs of it, he is going to wean me off slowly.... I will be decreasing my dose 250mgs each week til Im completely off. I started the Lamictal a week ago, and I will increase my dose of that each week til I reach 400mgs each day (200mgs in the morning, and 200mgs at night).

Im eager to see how things go.... Ive been on Keppra for over 11 years now!

[Redsaber]

He was planning to up my dosage to 500 but I guess he changed his mind. Yesterday I felt weak, a little light headed, and my muscles cramp. My hubby says the dr is a quack. Today my body aches like I ran a long race. I don't know if that is unusual. And also evertime I stop a med even a cold med I smell terrible like it's literally coming out of my pores and such. I already have kidney problems --- thus I figure the smell. Dont know - just a thought. Thanks guys n gals!