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Old 10-06-2018, 10:15 AM
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Trileptal Causing Elevated ALT

Hi all,

I recently received a report of blood work findings from my neurologist. My ALT is elevated at 50. The AST is climbing from what it was last blood work.

Is this cause for concern? My other anti-epileptic drug medication, while controlling seizures also caused this. The Trileptal I am now taking has controlled my seizures very well and I am just beginning to adapt to the side effects. I would hate to have to wean off of it, and I am not going to do anything with it until I hear from my doctor.

My doctor is supposed to call me Monday.

Do any of you know other options for medication? Medical Cannabis is not legal yet in Ohio. I am willing to try another anti-epileptic drug that is not metabolized through a hepatic pathway. Suggestions are welcome!


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Old 10-09-2018, 06:37 AM
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Hey Caleb --

Unfortunately, quite a few of the anti-seizure meds are metabolized through the liver. But there are three that are only partially metabolized by the liver: Keppra, Topomax and Zonegran. And there are two that are not metabolized by the liver: Neurontin and Sabril (Vigabatrin).

So while you and your doc are monitoring your liver function, you may want to have at least a preliminary conversation about some of the meds mentioned above.

Fingers-crossed that Ohio gets its CBD and medical marijuana rules figured out. From what I understand, some Ohio head shops are continuing to offer CBD oil despite the recent legislation (since they are confident that, as a hemp product, it's sale would ultimately stand up in a court of law). You should keep in mind, however, that CBD metabolism is still not fully understood. And iff you take CBD while also taking another medication it may slow the metabolism of the other med and potentially lead to toxic levels of that med.
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Old 10-09-2018, 08:11 AM
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Thanks for the reply Nakamova.

I used to live in Southern California, and recreational use of all kinds of drugs was common out there. I never got high myself, but there wasn't as much of an oppressive "dread" about drugs there was a kind of liberalism. I don't like the really bad drugs, and Ohio has been having a really bad problem with opiates, but I can definitely see the use of medical marijuana and I have come to the opinion that if it was regulated, it may not even be as harmful to use recreationally as a glass of alcohol.

I would never try these kinds of drugs, but I have a niece who was a frequent user of mescaline and LSD. She never had a mental collapse of any kind, her thought process just changed rather slowly over time. It has been fascinating to see. She went from being a very privileged, conservative, and superficial girl in a wealthy neighborhood and school, who was not interested in very many subjects at all to a young woman who has taken up clowning and a variety of mind-bending alternative lifestyles. She lived in an Orthodox Jewish neighborhood in Brooklyn for years and lived and dressed as a clown 24/7 to the consternation of many of her neighbors. She is a hard worker, but her thoughts are just "far out" (no pun intended).

For these reasons, I was always very skeptical about the scheduled drugs that were higher up on the list. But, I have re-evaluated some of those opinions, while not desiring to ever break the law. There are interesting studies and documentaries out there on these matters, and I am always learning.

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