changing epileptic drugs ?

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jeffc

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was wondering how your doctors do this as i have had more than 1 doctor and it`s like they went to different schools or think there way is the best, one of them will bring me up to the new dose of the new drug then wean me off the other drug and the other doctor raises the new one while lowering the old one at the same time.
 
Everytime I have had a change in medication my neuro has put me on the new medication gradualy increasing it every week until I reach the dose he wants. At the same time he gradually decreased the old medication.
 
In April of this year, my neurologist was trying to wean me off of Keppra, and put me on Lamictal at the same time. He was lowering my Keppra very slowly, every week I would go down 250mgs. I started out at 3000mgs and it would take me 12 weeks to get completely off the Keppra. At the same time, he was putting me on Lamictal, trying to get me to 200mgs a day. I will have to look back to see how high I got on the Lamictal, If I recall right, I think I got to 100mgs a day, and I was at 2500mgs of Keppra at the time I found out I was having an allergic reaction to the Lamictal, and had to be taken off the Lamictal. My dr kept me on the 2500mgs of Keppra, til I saw him three weeks later, and complained about a tingling sensation in my left foot and hand. They agreed to leave me on the Keppra, and due to the headaches I was having, they switched me back over to the Keppra XR, and since the medication only comes in 750mg tablets, they put me back to 3000mgs. It took the tingling sensations and headches right away. Ive been fine since. :)
 
Tapering/ramping schedules depend a bit on the meds and the dosages, as well as on your individual level of stability and medication-responsiveness. Some meds (like Dilantin and Keppra) can get up to a working dosage very quickly. Others, like Lamictal, need to be ramped up very slowly in small intervals, in order to lessen the possibility of an allergic reaction.
 
With all mine it's been the same

Decrease one very slowly at first, whilst increasing the new one at the same rate

Then after the first month or so increase them up a bit until you're done within the next month or two
 
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