Seizures during med changes--expected?

[lindsayschu2]

I'm in the process of switching from Topamax/Lamictal to Topamax/Keppra. Right now I'm on all three drugs. I just went from 500 Keppra/200 Lamictal to 1000 Keppra/150 Lamictal (Topamax staying the same) and am having some really mild simple partials. I'm hoping this is from dropping down 25% in Lamictal and is to be expected, and not some indictment that the new drug combination won't be as effective as the old. Lamictal gave me myclonics and that part is clearing up but frankly the simple partial series were a lot more impactful on my life. Anyone had experience with withdrawal seizures that went away when the new drug protocol got established?

 

[lindsayschu2]

Bumping, hoping for some thoughts!

 

[epileric]

I would mention it to your neurologist.

Personally though, I my non-medical opinion is that it would be better to lower the dosage of one only after you've reached the full dose of the new med.

 

[lindsayschu2]

She had me up Keppra only once--added 500, no reduction of Lamictal, then upped it to 1000, reduced lamictal to 150. Then I will reduce Lamictal by 50 mg every week until it's gone without replacing it. It concerns me a little but she is an epileptologist, but not so fond of seeing seizures increase! thanks Epileric ~Lindsay

 

[kirsten]

My doctor keeps me on the same dosage of the original drug until the new drug has been titrated up to full dosage unless something horrible happens with side effects. Something to consider is whether or not you've reached the expected levels with the new drug. This is the problem that I had seven months back but nobody thought to check levels, so I landed up in a train wreck.

 

[Nakamova]

Med transitions can always be a bit tricky for the brain, especially if you're on three while making the switch. With Lamictal it's best to transition extra-slowly (a good rule of thumb is to take at least as long for the taper as you did for the ramp-up). Ask your neuro about slowing the Lamictal taper -- either reducing by smaller increments of 25mg or by staying longer at each intermediated dose. Or both.

 

[Belinda5000]

seizures during med changes have always happened with me.
I've given up on trying any new since I'm refractory.and I've been on 23 different meds.
I have no more meds to chose from just Tegretol,Topamax,Phenobarb

 

[Juju26]

I've been on Keppra at 1500 2x daily since June 2013 and started Depakote just two weeks ago, and it driving me........CRAZY!!!!

I have already vomited twice and my muscle twitches have sky rocketed, I have an appt with my neurologist at the end of the month, so I think I won't be taking it anymore. The reason my doctor added a new script was because I was still having complex seizures, luckily I didn't stop taking Keppra so everything will be back to normal soon.

 

[lindsayschu2]

Thanks everyone. I'm seriously tired of meds, med switches, seizures, the whole damn thing. I'm in that place and I know you all know what I mean. I'm just going to slow the whole thing down because this isn't working that well. I have enough to slow it down on my own and I'm not that great about checking everything with my doctor (yes I'm sure someone will give me an earful about that!) But I honesty can't think of a negative in slowing down. I appreciate your thoughts!!

 

[kirsten]

I've been on Keppra at 1500 2x daily since June 2013 and started Depakote just two weeks ago, and it driving me........CRAZY!!!!

I have already vomited twice

I had this problem with valproate as well. Apparently it irritates your stomach lining, which is the reason for the nausea. I started a course of lancap, a stomach ulcer med, and it got better. After that, I'd need to do a few days of it here and there but I didn't need it constantly. You just need to take it two hours before and after your AEDs because it interferes with their absorption.