Negative response to Same Med, Same Dose, different dosing schedule

[bentwanderer]

I've been on Keppra 750 2x/d(bid) for 9+ months. We changed it to 500 3x/d (tid) about 2 weeks ago to give me more mid-day support especially when I'm out on my bike in the desert heat every day. Set alarms on my phone so I won't miss a dose. The alarms are working well to assure timely dosing.

But here's my question. I had a BIG negative reaction to switching to tid. No energy, flat affect, depressed, felt terrible, almost post-seizure terrible, but no seizure. After about 10 days on the new dose schedule all those negatives went away as if someone had turned off the negative switch.

Anyone else have a similar reaction to a change in the he frequency of taking your meds?

 

[arnie]

In my case the change in frequency was very beneficial. When I went from twice a day to four times a day I was able to increase the dose of my lamictal from 400 a day to 650 a day. Always before when I tried to increase beyond 400 (in 2x a day) I had bad side effects and no decrease in seizures. Apparently I am a fast metabolizer of meds so I need more frequent, smaller doses to reach a therapeutic level. Since I discovered that and made the change I am finally at a proper level of lamictal and have been seizure free for 3 1/2 months now!

 

[Nakamova]

I'm on Lamotrigine. Whenever I've changed doses -- up or down -- I experience side effects for about two or three weeks (dizziness, sleep problems) that eventually go away.

It can sometimes take a few weeks for the brain/body to "recalibrate" when a dose or dosing schedule changes -- it's sounds like that's what happened for you. Did you increase the amount of water you were drinking with the midday dose? That might have helped as well, since Keppra is excreted through the kidneys.

If the negative side effects return, you might want to try Keppra XR (extended release) if you haven't already. The XR half-life is the same as regular Keppra (approximately 8 hours), but it gradually peaks over the course of 4 hours (as opposed to one hour for the regular), so it might be easier on your system.

 

[bentwanderer]

I'm on Lamotrigine. Whenever I've changed doses -- up or down -- I experience side effects for about two or three weeks (dizziness, sleep problems) that eventually go away.

It can sometimes take a few weeks for the brain/body to "recalibrate" when a dose or dosing schedule changes -- it's sounds like that's what happened for you. Did you increase the amount of water you were drinking with the midday dose? That might have helped as well, since Keppra is excreted through the kidneys.

If the negative side effects return, you might want to try Keppra XR (extended release) if you haven't already. The XR half-life is the same as regular Keppra (approximately 8 hours), but it gradually peaks over the course of 4 hours (as opposed to one hour for the regular), so it might be easier on your system.

Nakamova, your post response was incredibly helpful. Thank you so much. I think you have described my experience exactly. And yes, my mid-day dose is connected to an increase in fluids. I'm most often out on my bike at the time riding about 50 miles in the desert, so lots of water at that time. Again, thanks for your insights and experience.