[Info] GREAT READ for all of us on epilepsy meds - pick yours!

[qtowngirl]

Although carbamazepine is by far the best AED in the treatment of focal and secondarily GTCS, it offers no benefit in most other epilepsies, because of ineffectiveness or seizure exacerbation; these include absences and myoclonic jerks of IGE, non-convulsive generalised seizures in Lennox-Gastaut syndrome and epileptic encephalopathies. Exceptionally carbamazepine may exaggerate seizures in Rolandic epilepsy and may induce non-convulsive status and features of serious atypical evolutions.

"the best AED in the..." WOW that is an astounding thing to read re: carb, been on it over 10 years.
whether you're on carb or any epilepsy med, this is the best thorough explanation (from a world-renowned book) i've found...

www.ncbi.nlm.nih.gov/books/NBK2597/

 

[Nakamova]

I've bookmarked the site, it's very handy.

I note that for my med (Lamictal) it says that for adult monotherapy "the usual maintenance dose to achieve optimal response is 100–200mg/day given once daily or as two divided doses." This agrees with the World Health Organization’s dosing recommendation. But drugs.com and other sites recommend maintenance doses of 250–300 mg/day or 225-375mg /day, and one even recommends 300–500 mg/day. This may seem like a little thing, but when I was first starting on Lamictal I had to fight with my then-neuro to stay at a sub-300mg dose. (And I had a known history of seizure control with lower-than normal medication dosages). I think that my neuro was biased by higher dosages recommended (pushed?) in the US.

I know that some people DO require the higher doses, but also think that there can sometimes be a too-rigid adherence to official "target" doses, particularly when the only real "target" is what works in each individual's case.

 

[SlimBlue]

Thanks for a great link I've got a lot of reading to do atm, but that book seems like one to add to the list.

I've reposted it in keppra, lack of attention, imperfectionism as it seemed useful- hope that's ok..

 

[AlexC]

Nakamova, I'm taking Lamictal as well, and they've recently upped my dose to 150mg 2 times a day. I'd prefer to stay there too, but my doc...eh...she's not the greatest.

 

[SlimBlue]

Alex, when I had to increase my Lamacital it was an arbitrary number of 50mg twice a day. My neurologist said under 50 would be negligible- but that's an extra 100mg every full day. It turns out 50 is the next number to increase by only because that's the smallest size tablet available.

In the end I stopped on 125mg for a while (halved them) instead of continuing ramping up, to see if it helped and it definitely has. My seizures aren't fully controlled but much less frequent, and I'm happy to stay at this level for now.

 

[AlexC]

I've got 25mg pills, so I dunno who told you 50 lol Anyway, the up dose has helped me as well. Same as you, I still am having seizures, though not as much and doesn't knock me out as much.

 

[Nakamova]

I'm on the 25mg Lamictal size as well. And when I was tapering up, my neuro had me cut those in half to 12.5mg in order to go as slowly as possible.

 

[SlimBlue]

It's just what the NHS over here will allow for perscriptions unfortunately, I guess it's got to do with bulk ordering of certain sizes to save costs.

 

[Cint]

"the best AED in the..." WOW that is an astounding thing to read re: carb, been on it over 10 years.
whether you're on carb or any epilepsy med, this is the best thorough explanation (from a world-renowned book) i've found...

www.ncbi.nlm.nih.gov/books/NBK2597/

Wish I could say the same thing ....... back in the late 80's and when my seizures started up again my neighbor at the time was a pharmaceutical rep, so she had a PDR (Physician's Desk Reference) and she gave me hers to start figuring out which med did what. I happened to be taking Tegretol at the time and that is when my nightmare began.

Now I use this website:http://www.epilepsy.com/epilepsy/seizure_medicines

 

[Cint]

I know that some people DO require the higher doses, but also think that there can sometimes be a too-rigid adherence to official "target" doses, particularly when the only real "target" is what works in each individual's case.

Yes, and I am one of those that does require the higher dose. But, :agree:, it is what works for each individual. And there have been times when I have told my neuro that I would absolutely not take the dose any higher.

 

[qtowngirl]

I'm on the 25mg Lamictal size as well. And when I was tapering up, my neuro had me cut those in half to 12.5mg in order to go as slowly as possible.

me too started with 25mg the first evening and when i woke up my eyes were swollen and two hours later the rash started up my arms, face and belly. my epi didn't think it was the med b/c i had only taken one, but said to take four days off and when rash was gone start again at 12.5. i knew damn well it was the lamot - i never have a rash and it's not a coincidence woman!!!
even at 12.5 the rash came back, and my eyes swollen and weeping lasted for a few weeks. from everything i've read it requires a slower titration than most e meds.
:clap: good times!

 

[MAB]

I've bookmarked the site, it's very handy.

I note that for my med (Lamictal) it says that for adult monotherapy "the usual maintenance dose to achieve optimal response is 100–200mg/day given once daily or as two divided doses." This agrees with the World Health Organization’s dosing recommendation. But drugs.com and other sites recommend maintenance doses of 250–300 mg/day or 225-375mg /day, and one even recommends 300–500 mg/day. This may seem like a little thing, but when I was first starting on Lamictal I had to fight with my then-neuro to stay at a sub-300mg dose. (And I had a known history of seizure control with lower-than normal medication dosages). I think that my neuro was biased by higher dosages recommended (pushed?) in the US.

I know that some people DO require the higher doses, but also think that there can sometimes be a too-rigid adherence to official "target" doses, particularly when the only real "target" is what works in each individual's case.

My partial seizures seem to be well controled on 150mg of genertic Lamictial per day. 100mg in the morning and 50mg in the afternoon. I see the neuro in Feburary and I am hoping she wil not want to increase it unless I have another seizure before then. I prefer to be on the lowest effect dose possible, especially since the worst of my blurry vision has cleared up.

 

[MAB]

Alex, when I had to increase my Lamacital it was an arbitrary number of 50mg twice a day. My neurologist said under 50 would be negligible- but that's an extra 100mg every full day. It turns out 50 is the next number to increase by only because that's the smallest size tablet available.

In the end I stopped on 125mg for a while (halved them) instead of continuing ramping up, to see if it helped and it definitely has. My seizures aren't fully controlled but much less frequent, and I'm happy to stay at this level for now.

My genertic Lamictal tablets come in 25mg strength. I take 4 in the morning and 2 in the afternoon.

 

[SlimBlue]

I'm sorry I didn't clarrify- 'available on the NHS'.

It's easy to forget we're not all in the same place.

 

[MAB]

I'm sorry I didn't clarrify- 'available on the NHS'.

It's easy to forget we're not all in the same place.

Sorry, I didn't read all the posts before I piled on.

 

[SlimBlue]

No worries lol and anyway- all you 'merkins saying you get a 25mg tablet just reinforces my point that it is a legitimate increase (else why is there one that size?!) and I shouldn't have had to be increased by 50 just because of NHS economics

 

[MAB]

No worries lol and anyway- all you 'merkins saying you get a 25mg tablet just reinforces my point that it is a legitimate increase (else why is there one that size?!) and I shouldn't have had to be increased by 50 just because of NHS economics

I agree, 50mg at a time is a large increase. I had just expericenced an allergic reaction to Keppra. I didn't want a 2nd bad reaction. Better to go slow.

I do think now that I am at a good dose I will ask for the 50mg pills. The 25mg pills are so tiny. I found one on the kitchen floor a couple days ago and had to get a magnifying glass out to tell what kind of pill it was. I thught it might have been my husband's Ativan.

 

[qtowngirl]

you got that right, ativan you can hardly see 'em! amazing the effect they can have being that small.

No worries lol and anyway- all you 'merkins

:roflmao: 'merkins, good one!

 

[SlimBlue]

 

[MAB]

you got that right, ativan you can hardly see 'em! amazing the effect they can have being that small.



:roflmao: 'merkins, good one!

Taking care of my 3 year old autistic grandson sometimes makes me wish I had an ativan saltlick I could hang around my neck.