Switching from Tegretol to Lamictal

[Annie4637]

Hello everyone,

I recently went to my neurologist for my yearly examination and I had some labs done. I am currently taking Tegretol XR 500 mg 2 x daily. When my doctor took my labs he found out that my liver enzymes were increased and as a result he said that he wanted to switch my medication from Tegretol to Lamictal 100 mg twice a day eventually. I was wondering if anyone else had done this because of inreased liver ezymes and what was their experience like. So far my seizures have been very well controlled under the Tegretol but I've read where people have had relapses because of switching to Lamictal. Any input on this matter would be greatly appreciated!

[Bernard]

Hi Annie, welcome to the forum.

I don't know anything about switching from Tegretol to Lamictal, and in general I wouldn't think switching meds when the one you are using is working is a good thing, however, if your liver is in trouble, you need to take care of it. It won't matter much what meds (or no meds) you take if your liver gives out. Just my opinion...

[HELP4U]

I did the above not because of a liver issue but because of lack of control by the Tegretol. However, I had to switch from Dilantin (which I liked for various reasons) to Tegretol due to lack of complete control, with a resultant need for add'l Dilantin and that is the point where the Neruo said: No more Dilantin. It's becoming Toxic and your liver will be affected.

Your liver CANNOT BE REPLACED. Have the meds & liver issues tested regularly. If you have control and your liver and meds levels are good, you should have no problems - BUT DON'T STOP HAVING THE LEVELS CHECKED. (I also take a Sodium/Potassium supplement [Thermo Tabs] to replace sodium flushed out of the body by the anti-epileptic drug's I take: lack of Sodium will cause seizures.)

I had to add Tri-leptal to the Lamactil due to lack of control by the Lamactil alone.

That still didn't work in terms of control, so I added Tranxene and this approach seems to be working almost all the time (except for a rcent trauma (falling off a brick staircase and tearing half the connective tissue in one arm: OUCH! No sleep for a week. A seizure ensued.)

This combo of meds has me in Outer Space sometimes, but perhaps that's the price I have to pay. (I also have many of the side effects that the contraindications on the med instructions said might accomany these meds, such as weight gain, intermittent loss of cognitive functioning, intermittent short term loss, thinning of hair, blahblahblah. My biggest problem is balance: BE CAREFUL whenever you switch for as long as you notice anything out of the ordiinary and mention it to your neurologist UNTIL you're satisfied that you know all you need to know about any issues.

I suggest that you adapt to your issues since they aren't going to adapt to you. (Yes, this might mean a change in meds or a change in docs some day in the future. Perhaps not. I hope the latter since a new-to-you neurologist will have to "learn you and your actions/reactions" before improving his/her ability to control your meds. NOt fun: sorry.

Don't know if this helps, but you have to take care of your internal organs
as well as your meds.

[kittykat2009]

hi Annie, im not sure about lactimal, but im currently on tegretrol retard 880mg at present, and get very zombie fied on this!!
as for liver ezymes mine are slightly high!! so they are doing regular blood tests to keep an eye on me!! im not being put on lactimal though but thinking of putting me on lamotrigine insted, as yet being on tegrtrol retard my fits are not fully controlled either!!
but i hope all works out for you
take care for now from kitty

[Bernard]

KK, Lamictal is a brand name for Lamotrigine. They are the same thing.

[merlotte]

hi friends... i was at the doctor the other day when i heard him prescribe someone with Zarontin(ethosuximide)....well, that made methink if i knew this medication but evades me. I was wondering what is it for...i read a little bit about it here-http://www.drugdelivery.ca/s3807-s-ZARONTIN.aspx and there are still some dark spots that i dnt understand...
what do you think about it?

[mariaine22]

Hey ive never been on tergretol, i was put on lamictal right away since i got diagnosed with epilepsy and let me tell you it just made everything worse. I started having grand mal seizures every day! and the f$#* doc woudl keeping increasing my dose which of course wouldn't help! so i switched doc's and meds...

[Bernard]

Good for you Mariaine, some docs just don't listen to their patients very well. Everyone reacts to anti-epileptic drugs differently and it is possible for them to increase seizure activity rather than decrease. It's a bunch of trial and error to see if there is a drug or drug coctail that gives you an acceptable balance of seizure control versus side effects.

[John-Forrest]

Hello, because I'd been having seizures despite the meds, tegretol for an number of years, then switching to dilantin this past year, so now my doc suggests I try lamictal to replace that. I'm starting on 25 mg doses (today), then working up to 100mg. / day. I tend to be suspicious of new drugs on the market and I'm really not sure if drugs do anything for me. A lot of times I think they just aggravate the condition, so that the seizures that do come out of the Pandora's box are even worse. I'm open to tyring something different, since this keeps getting worse. I still prefer to get into non-medical approaches; all meds do is repress the symptoms instead of fixing them. Incidentally, I just go to my family MD, I don't like the way neurologists want to dope you maximum to totally stop the symptoms - at the cost of making you a complete zombie.

[DianeParente]

My daughter had 4-5 grand mal seizures in 10 years on tegretol and has been switched to Lamitrogine and has had 5 seizures in 4 months (each seizure while on her period)...the dr wanted to add valproic acid to the lamitrogine but I did not think it was a good idea...we are trying bioidentical progesterone starting tomorrow and hopefully this will help!

[lureswinger]

I am just on my first day in swapping from tegratol to lamotragene I have already swapped half my tabs which were epilim to lamotragene but the neurologist wants me on lamotragene totally nothing else
I must admit I am very wary about doing this
The last time I tried swapping I was just reducing the tegratol without replacing it with anything and I only got 100mg down on tegratol before finding myself on the floor in the bank
At least this time I'm having something to replace the tegratol so fingers crossed things will go better

[Nakamova]

It's very tricky going from Tegretol to Lamotrigine because the two meds interact: Tegretol reduces serum Lamictal concentration by 40%. This means that Lamotrigine levels can rise significantly once you withdraw from the Tegretol, and you may feel side effects accordingly.

It's also been found in some studies that Lamotrigine can make Tegretol plasma concentrations higher/toxic. For these reasons, the dosage of both drugs needs to be calibrated very carefully during AND after the transition process, and the transition should be slow. I hope your neurologist is aware of these issues!

[CQ:)]

I was put on Tegretol in 2002 but in 2004 my neurologist put me onto Lamictal because the Tegretol wasn't controlling my partials.

He had intentions of getting me completely of the Tegretol & just on the Lamictal so was decreasing the doesages of Tegretol while gradually increasing the Lamictal.
I can't remember now but think my Tegretol was being lowered either every week or every few days. A couple of weeks after my neurologist started to change my meds I had a tonic clonic while at work, I barely ever take tonic clonics so think maybe the neurologist was decreasing my tegretol too quick.

After that my neurologist decided to keep me on both Tegretol & Lamictal.

Since then I have had a few changes in my epilepsy medications but have always been on 2 Anti Epilepsy Meds as my neurologist never tried to take me of Tegretol again.

[nicholasscott21]

I was changed from Lamotrigne to tegretol to clonazepam... Lamotrigne caused me great anxiety, tegretol can be used as a mood leveller and left me 'flat' and clonazepam seems to be doing the job- fits down from 70+ a month to 4, but I left clumsy and drowsy

[lureswinger]

Oh well second day on change from tegratol to lamotragene 6.30 am and breakfast all over the floor after a myclonic thank god for diazapam and at least the bowl didn't break oh well better get used to it lol as if I'm not already

[Anders]

I was switched from tegratol to lamotrogine in august last year.

I found I had a lot of nausea from them initially, but after a couple of weeks having completly switched i felt fine, i did have the lamotrogine increased by a further 100mg a few months later, but didn't go through the 25mg increases, and didn't have any nausea that time.

Think it may have just been some kind of conflict between the 2 meds for me, so that once the tegratol was out of my system it sorted itself out.

Also have found that since my first siezures my short term memory is rubish, not sure if this is down to the different meds i've had, or just a result of the epilepsy surfacing, so it might be something to watch out for.

[lureswinger]

Only two days into this change and already I'm getting sick of finding myself laid out on the kithen floor in a morning although I have dropped my breakfast thankfully so far I have not managed to smash any crockery all I can say is can I claim for crockery on the nhs as its not my idea to change my tabs its theirs its also making me feel nervous all day which when I spend all day looking after a dozen birds of prey and stood infront of 400 of the public dropping into a tonic clonic is not what I need

[lureswinger]

I also don't think it helps matters when I have to ask captain morgan to help keep me warm while standing outside all day at this time of year ( only a tot in my tea not nished as a pewt lol)

[Nakamova]

Definitely see if you can get in touch with your neurologist. For some folks, Lamotrigine makes myoclonic jerks WORSE. The below is from the wikipedia entry for Lamotrigine:

Lamotrigine can induce a type of seizure known as a myoclonic jerk, which tends to happen soon after the use of the medication. When used in the treatment of myoclonic epilepsies such as juvenile myoclonic epilepsy, lower doses (and lower plasma levels) are usually needed, as even moderate doses of this drug can lead to induction of seizures, including tonic-clonic seizures, which can develop into status epilepticus, which is a medical emergency.

[lureswinger]

Before the neurologist suggested getting shot of the tegratol I was begining to feel stable on lamotragene and tegratol but now he wants the tegratol out and me to be left soley on lamotragene I will say this much I had expected all hell to of broken loose just after my accident last year and am totally amazed that all I managed to suffer is the odd myclonic jerk but I have noticed that the way the mycloncs happen is totally different before when one happened it was a case of hands flicking cups across rooms and a deffinate jerk involved but now they appear to be more like the muscles just relax for a split second meaning rather than a flick so it feels like my hand just opens and whatever I'm carrying just falls out