med increase = thumbs down

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chop456

chop456

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Paige went up to 300mg of lamictal 3 weeks ago and I swear she is having more issues now than before. She will have myoclonics well after waking up and last night had some at 7pm and again at 10pm. Ugh. I called the doctor's office and left a message. If we go back down to 250om but did not have full control with that what are we to do? Will they wean her off lamictal and try another or add something to the lamictal? I really want lamictal to work. :(
 
Maybe, just maybe, this is the reason why. If you have any information regarding this, I'd love your input.

When Paige had her wisdom teeth out she was prescribed hydrocodone/acetaminophen (7.5-750T) and ibroprophen (600 mg). She was taking these meds every 4-6 hours for 10 days. Could this be why her myoclonics seem to be less controlled since her med increase? If there an interaction between either of the pain meds?

Thank you for any input.
 
When I've had meds not work for me, they add the new one first, and after that is therapeutic, they wean off the old. In my case they never tried polytherapy until recently, so they will may continue going with monotherapy if they think they can make it work. I can't really say for sure though, and I don't know if they will switch. Sometimes that stuff really just depends on the doctor though.

I hope she finds good seizure control soon! *hugs*
 
Oh, we cross posted. I would say it is possible that it's the other meds. I don't know for sure, but it sounds like something that could effect seizure threshold. Interested in what others might say.
 
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I think there's only a minor interaction between Lamictal and Hydrocodone (basically that there's more of a sedative effect) so I would rule that out. But acetaminophen may slightly lower Lamictal levels, so that could be a factor. If Paige's sleep was qualitatively disrupted by the pain meds, that might also be a stressor that could be triggering some of her symptoms.

Unfortunately, it's also the case that Lamictal INCREASE myoclonic seizures (especially nocturnal myoclonus) for some folks. If she's given the Lamictal increase a decent shot, and you can rule out other factors, then it might not be the best med for her.
 
She had been doing ok on lamictal for 9 months. She was having occasional myoclonics - say 1-2 days every 2 weeks. When we upped her dose she went 2 weeks with nothing and then AFTER her wisdom teeth were out she started having issues. I did some research and one of the pieces I read said that hydrocodone acetaminophen could lover the blood levels of lamictal. Here is what it said...

"LAMOTRIGINE (in Lamictal XR) may interact with ACETAMINOPHEN (in Hydrocodone and Acetaminophen Tablets)

Although the cause of this potential interaction is not clearly understood, acetaminophen may decrease blood levels of lamotrigine. This could make lamotrigine less effective. Based on information from one study involving a small number of healthy people who took these drugs together, using no more than the recommended dose of acetaminophen every day for a short period of time (I.e., less than 2 weeks) does not appear to have an effect on a dose of lamotrigine. However, this potential interaction may be more likely to occur when acetaminophen is taken on a daily basis for a long period of time. If these drugs are used together, your doctor may want to monitor you to make sure that you are not experiencing problems and adjust the dose of lamotrigine if needed.You may want to ask your healthcare provider about this potential interaction if you think you are having problems."

However, Paige was only taking the pain meds for 10 days. I am so bummed. I was really hoping lamictal was going to work for her. Ugh.
 
If those ten days overlapped with her Lamictal increase, then you may want to give it at least another week (if she can tolerate it).
 
She can tolerate it. Sadly it's this mom who has a hard time seeing her go thru this.
 
Well, the neurologist called and we are going to see her today. Paige had no myoclonus this morning. Yeah!
 
I recall taking Hydrocodone during the time I went to the ER for bronchitis. I couldnt breath and was taken my ambulance in November 2011. Turned out they dx'd with bronchitis and prescribed Hydrocodone. within days of taking it, I started having seizures. I didnt put the two together, til I ran it by my neuro's nurse. She said to stop taking the hydrocodone. It was causing the seizures. Once that stopped, the seizures stopped. At that time, I was taking Keppra XR. But I did take Lamictal in April 2011. I was only on it for two weeks and had to be taken off to a severe allergic reaction to it.

Thats great that paige had no seizures this morning! :)

Let us know how the drs appointment goes!
 
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