Changing med from Triletal to Topomax

[Jeanne Shamji]

March 23

This is an email I sent to my Dr. regarding the meds I am currently taking. The doctor is planning on taking 7 weeks to switch me to a total of 225 Topomax, 50 mg Vimpact and 200 mg Lamictal daily. I'm feeling so extremely sleepy and lethargic and it is really affecting my life and work. I really do not want to increase the amount of medication I have to take. It seems that I have seizures in 3 week cycles - we don't know why, but about every three week I have a grand mal and a couple of petit mals and then I take a Lorazepan.

Dosages (Each pill):
Trileptal 300 mg
Topomax 25 mg
Vimpact 50mg
Lamictal 200 mg

I am now on the 3rd week of switching from Trileptal to Topmax:
AM Afternoon Night
Trileptal 0 Trileptal 0 Trileptal 1/2
Topomax 1 Topomax 1 Topomax 1
Lamictal 1/2 Lamictal 1/2 Lamictal 1
Vimpact 1 Vimpact 1 Vimpact 1

and the side effects that I am experiencing are extreme sleepiness, (yawning all day, lethargy) diarrhea, loss of memory, deja vu, fogginess, and just feeling "dumb" while on last week's meds:

2nd week
AM Afternoon Night
Trileptal 1/2 Trileptal 0 Trileptal 1/2
Topomax 1 Topomax 0 Topomax 1
and same for Lamectal and Vimpact

I seem to have none of the negative side effects, except the deja vu, and felt much more alert.

I have not have any seizures, and had "floaters" (visual fogginess) in my left eye) for a short period once last week and twice this week.

Instead of continuing with increasing the dosage of Topomax, should I stay at last week's level of Trileptal plus Topomax to see if this cures my seizures?

I have not had any seizures since March 11th.
Please let me know what you think.

 

[Nakamova]

Hi Jeanne, welcome to CWE!

Everyone reacts so differently to meds, it's hard to advise you. (Of course neurologists are also in the dark when it comes to predicting what meds or dosages will work, so their recommendations are essentially educated guesses based on average dosing guidelines and what they know of your medication history).

In my own case, I stopped short of a target dosage that my neurologist wanted me to hit. I was supposed to ramp up to 300mg lamictal/day, but I stopped at 250mg, and have since tapered down to 175mg, with no problems or seizures. When I made my decision to do so, I felt I had a pretty good sense of how my brain was reacting, and I was comfortable with the potential consequences if I was wrong.

If you feel okay with the risks (potential seizures), and optimistic about the benefits and the best-case scenario (no seizures or side effects), then I would say you should go ahead and stay at the level you are at. It's a good idea to let your neuro know what you are doing. (I say this even though that's not what I did. )

Best,
Nakamova

 

[Endless]

March 23

I seem to have none of the negative side effects, except the deja vu, and felt much more alert.

I have not have any seizures, and had "floaters" (visual fogginess) in my left eye) for a short period once last week and twice this week.

I have not had any seizures since March 11th.
Please let me know what you think.

Hi, Jeanne,

Welcome!

Deja Vu is a seizure - a simple partial temporal lobe seizure. So it looks like you may have had one.

It takes a long time to get the mix and dosage of meds right. Everybody is different, everyone's reactions and seizures are different. I'm still monkeying with mine to get them right. I'm not the best of patients because I tell my neurologist about it later. Right now I'm on 200mg of Lamictal and 300+mg of Diamox. I think my Lamictal needs to be higher.

I know it takes patience, but I've found it's best (at least for me) to change only one drug at a time, so I know how the dosage change is affecting me. If I change a bunch of stuff all at the same time and my seizures return or get better, or I start getting side effects, I don't know what caused what.

Good luck. Will you let us know how you are doing?

 

[mel239]

Just curious why you are switching off trileptal?Thats what I take and about every 4 mos my seizures start creeping back-more frequent but less severe.yesterday were all simple partials lasting less than 5 seconds accompanied by extreme rage and breaking down in tears.I had about 7 or 8 yesterday and 3 the night before.But my biggest complaint are severe headaches.