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Break Through Seizures on Lamictal??
Fri, 06/19/2009 - 19:18Hi everyone. I have several questions and Im very confused right now, maybe someone can shed a light on this situation. Im 24, I had my first grand mal seizure 4 years ago. I was hospitalized because I hit my head and was knocked out for a day straight.. About half a year after, I had another seizure, in my sleep and was taken to the hospital as well. This time a resident neurologist prescribed Lamictal to me. He told me to build up, 25mg, then 50.. etc till I finally reached 100mg tablets, twice a day. Everything was perfect, 2 years I havent had a single seizure..
The Doctor and I have descided to try to lower the medication, or get rid of it completely, since my EEG and MRI's showed no problem, and no-one in my family has ever had seizures.. We began lowering the dose, and as soon as it got to 25mg, twice daily, I had another seizure.. Then we decided to go back to the dose I was taking, and I slowly began building up back to 100mg twice a day.. On my way up I had another seizure.. afterwards I stayed on 100mg twice a day, and everything was fine for about another 6-7 month.
Then I was moved to generic, lamotrigine, and I don't know if it was a coincidence or not, but I had another grand mal seizure.. My doctor moved me to Brand name Lamictal again, and got the autorization from my insurance so I get Lamictal, not generic.. He also bumped up my dosage to 100mg morning, and 150mg at night.
Everything was fine for another 5 months, then last week I had another seizure, right before I was about to go to bed.. I thought it was because I took my Lamictal a few hours later then I usually did. Then 3 days ago, I had another grand mal seizure, this time right after I woke up.. Now Im worried.. I have never had seizure so frequently. This time I was taken to a hospital. They put the EEG on my as soon as I arrived, and did not give me any Lamictal at all. I was on the EEG for 3 days,I was sleep deprived since the hospital kept me awake most of the night + I didnt take any lamictal while I was there, and still didnt have a single seizure.. After 3 days of testing, they said everything is fine and discharged me.
Now I do not understand, does this mean the Lamictal is not working for me anymore, or was this a break through seizure??? (To be honest I was kinda stressed and tired, and lacked some sleep this past week) But since I was on lamictal I though that wouldnt matter.. My neurologist is not telling me anything usefull, just bumped up my dose of Lamictal another 50 mg. Now its 150mg morning, 150mg at night.. I was pushing for 200mg twice a day, but he said they only increase little by litte, since too much of it might also increase seizures. But somehow I find it hard to believe that the extra 50mg will keep me safe.
Also what seemed weird is that, my aura before a seizure, is the same as a side effect of Lamictal.. I get really dizzy moments before a seizure happens..
Did anyone experience anything like this?? Does this mean my body is adapting to Lamictal and reducing it effect.. Im not really comfortable having a seizure every 3-4 months, and then having my dosage bumped up another 50mg.. If everything was fine before, even on 100mg twice a day.. Can someone shine some light on this situation??? I would appreciate it..
Comments
Re: Break Through Seizures on Lamictal??
Submitted by Cure JME on Sat, 2009-11-14 - 21:14
Hi everyone!,
I have had JME since I was 17 (in my 40s) now. I'm also on Lamictal and take 800 mg/day. I take the name brand because I was having breakthroughs on the generic brand. Unfortunately the drug just doesn't seem to be controlling my seizures that well anymore. Last Tuesday I had an upset stomach in the middle of the night and became very dehydrated because of it. When I went back to bed my wife told me that I had a GM in my sleep. I suspect that my medication didn't get absorbed because of my upset stomach but that still doesn't make me feel any better. Has anyone else had this problem?
It seems that I'm too much on the edge. I'm waiting for my epileptologist to get back to me with some ideas. I'm concerned that if another drug is added that my cognitive abilities will be compromised. Also, If I have an upset stomach in the future I'm concerned that I could be at risk for a seizure no matter how much mediciation I'm on. The water that floods our small intestine when we have an upset stomach may flush out the medication preventing it from being absorbed. Thoughts anyone? I'll post again after my epileptologist gets back to me. As you all know seizures are very difficult to deal with both emotionally and physically and I admire all of you for persevering.
Warmest regards,
Mark
Hi everyone!,
I have had JME since I was 17 (in my 40s) now. I'm also on Lamictal and take 800 mg/day. I take the name brand because I was having breakthroughs on the generic brand. Unfortunately the drug just doesn't seem to be controlling my seizures that well anymore. Last Tuesday I had an upset stomach in the middle of the night and became very dehydrated because of it. When I went back to bed my wife told me that I had a GM in my sleep. I suspect that my medication didn't get absorbed because of my upset stomach but that still doesn't make me feel any better. Has anyone else had this problem?
It seems that I'm too much on the edge. I'm waiting for my epileptologist to get back to me with some ideas. I'm concerned that if another drug is added that my cognitive abilities will be compromised. Also, If I have an upset stomach in the future I'm concerned that I could be at risk for a seizure no matter how much mediciation I'm on. The water that floods our small intestine when we have an upset stomach may flush out the medication preventing it from being absorbed. Thoughts anyone? I'll post again after my epileptologist gets back to me. As you all know seizures are very difficult to deal with both emotionally and physically and I admire all of you for persevering.
Warmest regards,
Mark
Re: Break Through Seizures on Lamictal??
Submitted by scorpio on Tue, 2009-11-17 - 17:14
Mark. I have TLE and, like you, take Lamictal, 200mg/d, rather less than the - what seems excessive to me - 800mg you take. My epi is more or less controlled to the extent that I am now driving a car. However, something I only discovered ten years or so ago, my seizures only occur when I am dehydrated. Mild and infrequent at first, they disappear after a glass or two of water (a warning sign here, before any seizures occur, is a dark colour to one's urine). There can be one or two mild 'aftershocks' but they are not significant. A similar course of events takes place if I forget to take one of my twice-daily doses of the drug.
As to your medication not being 'absorbed' you might not know but Lamictal has a longish half-life, around 30-35 hours, so the effects of dehydration are unlilely to be immediate - and that is my experience. Which is fortunate in that it gives one time to do something about it. Everyone is different in their reaction to different AEDs/their side-effects and maybe your upset stomach did set off a seizure or two, for whatever reason. Still, it migth be worth monitoring any correlation between dehydration and your seizures, especially in the context of long-haul flights, arid climates, too much alcohol etc etc. I hope things improve.
Chris
Mark. I have TLE and, like you, take Lamictal, 200mg/d, rather less than the - what seems excessive to me - 800mg you take. My epi is more or less controlled to the extent that I am now driving a car. However, something I only discovered ten years or so ago, my seizures only occur when I am dehydrated. Mild and infrequent at first, they disappear after a glass or two of water (a warning sign here, before any seizures occur, is a dark colour to one's urine). There can be one or two mild 'aftershocks' but they are not significant. A similar course of events takes place if I forget to take one of my twice-daily doses of the drug.
As to your medication not being 'absorbed' you might not know but Lamictal has a longish half-life, around 30-35 hours, so the effects of dehydration are unlilely to be immediate - and that is my experience. Which is fortunate in that it gives one time to do something about it. Everyone is different in their reaction to different AEDs/their side-effects and maybe your upset stomach did set off a seizure or two, for whatever reason. Still, it migth be worth monitoring any correlation between dehydration and your seizures, especially in the context of long-haul flights, arid climates, too much alcohol etc etc. I hope things improve.
Chris
Re: Break Through Seizures on Lamictal??
Submitted by Terribee on Sat, 2009-11-14 - 17:28
Do you take more than one medication? I was taking Clobazam and Lamictal for years but my body got used to the Clobazam so I had to switch to Lamictal and Keppra. I experience breakthrough seizures all the time. I also lose a fair amount of hair but I think it's a combo of medication and stress. I know that my seizures have gotten worse as I get older and they're a little harder to control. If I were you, I would maybe stick it out for a couple of more weeks to see if the dosage increase is actually effective or asked to be switched to a different med. I would also ask the doctor if he/she thought monotherapy is effective enough or if you need to have a combo of seizure meds (I hope that's not the case!). Thinking of you,
Terri
Do you take more than one medication? I was taking Clobazam and Lamictal for years but my body got used to the Clobazam so I had to switch to Lamictal and Keppra. I experience breakthrough seizures all the time. I also lose a fair amount of hair but I think it's a combo of medication and stress. I know that my seizures have gotten worse as I get older and they're a little harder to control. If I were you, I would maybe stick it out for a couple of more weeks to see if the dosage increase is actually effective or asked to be switched to a different med. I would also ask the doctor if he/she thought monotherapy is effective enough or if you need to have a combo of seizure meds (I hope that's not the case!). Thinking of you,
Terri