Hi all,
I've been on Keppra for almost 12 years, and I think I may have had only two or three blood level tests in that time. I've been fortunate to be well controlled by Keppra and have tolerated it well after my initial years settling in.
A few weeks ago, my doc asked that I do a Keppra blood test since it has been a while. Taking the test before my first morning dose (so 12 hours since my last dose), he said my level was 11.8 on a range of 12 to 46. As a result, he wanted to increase my Keppra dosage.
Does this increase seem warranted and necessary?
My understanding with Keppra is that levels were rarely taken and not always accurate, so the idea was to treat the patient and not adhere to a strict lab guideline.
1. I have not had one seizure episode in the 12 years I've been at my current dosage.
2. Also, I've ready different reference ranges for the same unit of measurement depending on where you get the information. For example, Cleveland Clinic says 5 - 45, Mayo Clinic says 10 - 40, Lab Quest says 12 - 46.
3. I had to wait at the lab for a while, so the time of the test was later than usual, and even then, the result was barely below the "reference range."
4. I've also read that given the difficulty of determining which Keppra level is truly therapeutic, and an article from the NIH stated not to be a slave to those ranges and treat the individual patient based on seizure control and side effects.
Knowing all that, I am pushing back against my doc wanting to increase the level, as it seems a rather arbitrary decision given my strong history of seizure control and good quality of life.
Any thoughts?
I've been on Keppra for almost 12 years, and I think I may have had only two or three blood level tests in that time. I've been fortunate to be well controlled by Keppra and have tolerated it well after my initial years settling in.
A few weeks ago, my doc asked that I do a Keppra blood test since it has been a while. Taking the test before my first morning dose (so 12 hours since my last dose), he said my level was 11.8 on a range of 12 to 46. As a result, he wanted to increase my Keppra dosage.
Does this increase seem warranted and necessary?
My understanding with Keppra is that levels were rarely taken and not always accurate, so the idea was to treat the patient and not adhere to a strict lab guideline.
1. I have not had one seizure episode in the 12 years I've been at my current dosage.
2. Also, I've ready different reference ranges for the same unit of measurement depending on where you get the information. For example, Cleveland Clinic says 5 - 45, Mayo Clinic says 10 - 40, Lab Quest says 12 - 46.
3. I had to wait at the lab for a while, so the time of the test was later than usual, and even then, the result was barely below the "reference range."
4. I've also read that given the difficulty of determining which Keppra level is truly therapeutic, and an article from the NIH stated not to be a slave to those ranges and treat the individual patient based on seizure control and side effects.
Knowing all that, I am pushing back against my doc wanting to increase the level, as it seems a rather arbitrary decision given my strong history of seizure control and good quality of life.
Any thoughts?