The story so far and which drug to choose??

[aparentofasonwithepilepsy]

Hi I have been here a few times and posted too. Some will remember my son was diagnosed with Complex Partial Seizures. He had an MRI and it showed nothing besides for a prominent right frontal vein. They epileptologist did not think that is what causes the seizures.

However, the Keppra has not stooped his seizures and has had some side effects including behavior changes the doctor now wants to change his meds. Here are the options that were given to us together with the side effects:

1. Lamictal (which has very few side effects and no problems with behavior. The main issue is that it can cause an allergic rash if it goes up too quickly and therefore, it takes about 2 months to reach low therapeutic levels).
   
2. Trileptal (side effects: may have issues with behavior, although less than Keppra)
   
3. Zonegran and Topamax (side effects: weight loss and sleepiness)
   
4. Depakote (side effects: weight gain, and rarely liver toxicity and platelet problems).

We are not sure what to say and will be having a proper consultation with the Epileptologist tomorrow. Does anyone have any suggestions about what to ask and what medication to avoid?

Thanks in advance.

 

[epileric]

It's hard to recommend anything because everyone reacts differently to different medications.

I honestly think the only option is to try one & see how it works for your son. If the side-effects are worth the curative effect then it's worth staying on.

Of course there are other alternative therapies that can help lessen the dose of meds which will hopefully lessen the side-effects. http://www.coping-with-epilepsy.com/index.php?p=alternative-treatments

Good luck, keep us updated on what you'd decided for your son & how he's coping.

 

[Meetz1064]

I have

been on Lamictal and Depakote both, before.......at the same time. That didn't work. There were memory issues in a big bad way, AND I gained 100+ pounds. Now, I also have a thyroid problem, so that may have contributed to the issue a bit also, but not entirely.

I am trying Lamictal again right now....and am doing that slow titration of which you speak. OY. I have made it through the first 3 weeks so far, with no problems, except being drop dead tired no matter how much I sleep. It seems to be getting better the last day or so...but I will be upping the med again in about a week.

Eric is right. We are all very individual, there is really no way to know what will work........I wish you the best of luck, though.

Take care.

Meetz
:rock:

 

[skillefer]

Honestly, it's hard to say...one person may have horrendous side effects while another person with the same type of seizure won't have any side effects at all. It's a matter of what works best for your child. Also, don't be surprised if your child ends up changing meds several times throughout his life. Sometimes, when you've taken them for years, they just quit working...

 

[rackelsmom]

Good Morning. So sorry Keppra didn't stop your son's sz's. That is the same drug they started my daughter on and it didn't work for her either. What everyone else said about side effects is spot on, indiviual responses. I think the longest honeymoon phase we had was with the lamictal, she was on all the meds you mentioned and truthfully they all seemed about the same to me. I hope you are able to gain good control on a new AED. Be sure to let us know how todays appointment goes...

Blessings,
Ann

 

[Kansas Educator]

The other posters are right -- there is no way to predict what works on one person or another. I am on Depakote ER and that is the only medication I have been on. It controls my complex partial seizures but has caused elevated liver enzymes and has slightly lowered my platelet counts. I would just recommend working with your neurologist to select the best option and then working with him/her to make changes as necessary. Also, I'd try some of the alternative treatments too to reduce the amount of meds he has to take. Good luck!

 

[Bernard]

If it were me, I'd try the Lamictal first. It is generally well tolerated compared to the others (barring the skin rash) from what I see on the forums.

Hair loss is a pretty common side effect with Depakote too.

 

[Blondie47]

Our AED trials

13 yr old daughter - list of drug trials - simple partial, multi focal, sometimes with motor or vision impairment

Tried Keppra no control, depression, exhaustion.

Tried depakote ok control, weight gain, exhaustion, tremors, hair loss.

We are on a trial of generic Trileptal right now ( until 6/15). The control is very, very good but still not 100 percent. No side effects. 600mg 2x daily.

If the Trileptal fails, we will then move on to Lamictal. Our doc needed 100 percent control on Trileptal for us not to move on to lamitcal.

Hope this helps in some way!