Medication side effects worsen post-seizure??

[masterjen]

Hi
I'd really like some help understanding this, and also I'm curious as to whether anyone else has experienced it.
I generally don't have too much difficulty with medication side effects. Occasionally I have a slightly dizzy/sleepy feeling that starts about 1/2 hour after taking the daytime dose and it generally lasts for an hour, and then I'm completely fine.
If I have had a seizure (nocturnal, every 4-5 nights), I am generally wiped out the next day so if I was experiencing any side effects from a daytime dose I'm not sure I'd notice. Then the following day I typically will have very strong side effects from the medication, to the point of almost double vision along with light sensitivity, mild to moderate imbalance/dizziness, and feeling sleepy. This can last for a few hours.
These are symptoms similar to what one would have if the medication dose was too strong. So why would I have these strong (or stronger) side effects post seizure like this? It crosses my mind that maybe the medications themselves are causing the seizures (eg. too much medication), but if this was the case wouldn't the seizures would be happening more often and/or wouldn't I be experiencing strong side effects more often?
Any help understanding this would be greatly appreciated!

 

[QueenieKP]

What you describe sounds very similar to what is 'normal' my post ictal state after having a seizure. Obviously, discuss with your health care provider but it sounds like normal side effects of a seizure rather than the meds.

Q

 

[Nakamova]

Is it possible that when you are "generally wiped out the next day" you may be eating/drinking less than normal? That might affect how the meds make you feel, even the second day after the seizure. And/or if your metabolism has been affected by the seizure, maybe the clearance rate is slower on days 1 and 2 post-seizure.

Is your medication an extended-release variety? Another possibility is that its release schedule doesn't match with your metabolism, so every 4 to 5 days the "overlap" when you take your dose is in effect putting a bit too much medication in your system.

 

[masterjen]

Hi, Nakamova - I understand what you're saying in the first paragraph, except I'm not sure what you mean by "overlap" in the second paragraph.
Of note if it helps: I take Keppra and Vimpat which are not extended release, but also Tegretol which is extended release because I couldn't handle the sudden "hit" of regular release.

 

[Nakamova]

Ideally, all three meds you are taking would metabolize in such a way so that you would have steady amounts in your system all the time. But it might not work that perfectly, particularly since one of them is extended release. You might have medication peaks and troughs happening irregularly, sort of like three clocks that are keeping very slightly different time: As they go in and out of synch, sometimes all three show the correct time, sometimes maybe two of them agree, and sometimes none of them agree. So you might be undermedicated at times, overmedicated at other times, and reacting to the fluctuations.

Tegretol can also slightly decrease the amount of Vimpat in the blood, an interaction that could also be contributing to fluctuating or inconsistent medication levels overall. The Tegretol might be the one that's overloading you every few days -- the side effects associated with having too much in your system (particularly photosensitivity, but also nausea, fatigue, lack of coordination, confusion) are the ones that you describe.