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Max. allowable dose of lamictal

Fri, 11/19/2010 - 11:36
Topic: Living With Epilepsy - Adults
In scanning several threads, I've noted that many people are on fairly high doses of lamictal (whether or not combined with other drugs). The highest dose I've read about so far in this forum is 450 mg. I am currently on 200 mg, and potentially will be increased to 250 - 300 mg. I've read that at doses of 300 mg. and higher that lamictal is being used as a med for bipolar (and perhaps depression, but I'm not sure). I definitely don't have either of those conditions, and probably none of you taking these higher doses does either. This leads me to the following questions: 1. What is the max allowable dose of lamictal? 2. Do higher levels of lamictal offer even greater seizure control? PLEASE correct me if I'm wrong, but I thought lamictal's effectiveness for controlling seizures "plateaued" once you reached 300 mg, and that's why at these higher doses it is considered a bipolar drug rather than an AED. Thanks in advance for any help!

Comments

Re: Max. allowable dose of lamictal

Submitted by phylisfjohnson on Fri, 2010-11-19 - 18:03

I can only tell you what I've been told by my doc. At its lowest level, Lamictal is an anti-anxiety drug. At its next level, it's an anti-anxiety and anti-seizure med and theoretically, beyond that, it's for bipolar people.

I'm at 300MG, possibly changing to 400MG. Just because I've been having a lot of accidents (falling down the stairs, etc.) that have led to dire consequences.  (I have stictches in BOTH legs!)  But I think 400MG is supposed to be the limit of effectiveness.  At least as far as I know.

And I do have life-long clinical depression. I think Lamictal helps with that, but I'm not sure, because the Lamictal is supplemented with Klonopin, another anti-anxiety, anti-seizure med.

It's always good to hear from you.  Hope you're faring well.     Phylis Feiner Johnson   www.epilepsytalk.com

 

I can only tell you what I've been told by my doc. At its lowest level, Lamictal is an anti-anxiety drug. At its next level, it's an anti-anxiety and anti-seizure med and theoretically, beyond that, it's for bipolar people.

I'm at 300MG, possibly changing to 400MG. Just because I've been having a lot of accidents (falling down the stairs, etc.) that have led to dire consequences.  (I have stictches in BOTH legs!)  But I think 400MG is supposed to be the limit of effectiveness.  At least as far as I know.

And I do have life-long clinical depression. I think Lamictal helps with that, but I'm not sure, because the Lamictal is supplemented with Klonopin, another anti-anxiety, anti-seizure med.

It's always good to hear from you.  Hope you're faring well.     Phylis Feiner Johnson   www.epilepsytalk.com

 

Re: Max. allowable dose of lamictal

Submitted by Terribee on Fri, 2010-11-19 - 20:24

Hi there:

I've been taking 450 mg of Lamictal for 7 years--and I'm definitely not bipolar!. Around that that time of month I add one more, 600mg in total. It seems to work well since my seizures are mostly catmenial.

Teresa

Hi there:

I've been taking 450 mg of Lamictal for 7 years--and I'm definitely not bipolar!. Around that that time of month I add one more, 600mg in total. It seems to work well since my seizures are mostly catmenial.

Teresa

Re: Max. allowable dose of lamictal

Submitted by Texas_med on Sat, 2010-11-20 - 14:56

My name is Shawn. I am a Nurse and EMT in East Texas. I have seizures as well and can help you out with your concerns. I can tell you that the recommended maximum dosage for lamictal is 500 mg. The large group of neurologists I work with have told me that the dosage that a patient is put on depends on several factors. The two main factors in determining the proper dosage are weight and metabolism. One example I can give (as the neurologists have told me) is that a 21 year old athlete will most likely have to have a larger dose than 45 year old office worker. The key to that is the athlete burns more calories much quicker, so the body will get rid of the medication much quicker and be out of the therapeutic range as well. If you are on your feet a bunch or are still young, that may be the main key to increasing the dose. The blood serum tests are really the only way to determine if you are staying within the therapeutic range on your dosage.

I can tell you I am a good example though of using medication over the recommended maximum dosage. I am on Carbatrol and Keppra. I take 5000 mg of Keppra daily whereas the maximum recommended dosage is 3000 mg/day. My blood tests were showing that the 3000 mg/daily was getting me nowhere near the therapeutic range. They had to raise it to 5000 mg/day and I have actually had better control of my seizures than I have in over 17 years. The main key to the dosage though is what the blood serum tests show to determine if you are within the therapeutic range and if you can tolerate the side effects (if there are any). I wish you the best of luck. If you have any questions, feel free to e-mail me.

My name is Shawn. I am a Nurse and EMT in East Texas. I have seizures as well and can help you out with your concerns. I can tell you that the recommended maximum dosage for lamictal is 500 mg. The large group of neurologists I work with have told me that the dosage that a patient is put on depends on several factors. The two main factors in determining the proper dosage are weight and metabolism. One example I can give (as the neurologists have told me) is that a 21 year old athlete will most likely have to have a larger dose than 45 year old office worker. The key to that is the athlete burns more calories much quicker, so the body will get rid of the medication much quicker and be out of the therapeutic range as well. If you are on your feet a bunch or are still young, that may be the main key to increasing the dose. The blood serum tests are really the only way to determine if you are staying within the therapeutic range on your dosage.

I can tell you I am a good example though of using medication over the recommended maximum dosage. I am on Carbatrol and Keppra. I take 5000 mg of Keppra daily whereas the maximum recommended dosage is 3000 mg/day. My blood tests were showing that the 3000 mg/daily was getting me nowhere near the therapeutic range. They had to raise it to 5000 mg/day and I have actually had better control of my seizures than I have in over 17 years. The main key to the dosage though is what the blood serum tests show to determine if you are within the therapeutic range and if you can tolerate the side effects (if there are any). I wish you the best of luck. If you have any questions, feel free to e-mail me.

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