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Adding Lamictal while taking Dilantin

Sat, 09/23/2006 - 09:41
I have been on Dilantin for 33+ years. My seizures have greatly increased in frequency. I am thankful, based on what many of you share on this site, that my seizures have been relatively infrequent. I have gone as long as 10 years without one. However, since turning 52, they have increased to one every three to four months. I went to a seizure specialist for the first time in my life. He is putting me on Lamictal with the plan of getting it regulated and then gradually removing the Dilantin. Has anyone gone through this before? If so, how was the transition. My research indicates it can be tricky. Thanks, Woody

Comments

Re: Adding Lamictal while taking Dilantin

Submitted by jslenk1103 on Wed, 2009-02-11 - 20:18
I was diagnosed January 16 with epi and have had two grand mals. The side effects from Phehytoin were really messing wiht me. It was making me depressed to a point I had never been before in my life. Today I saw a new Neurologist who I really like and he is switching me to Lamictal using almost that 6 week plan you just described. I hope the side effects are better with Lamictal than Phenytoin. Good luck. I will be sharing youir experience starting tommorrow.

Re: Adding Lamictal while taking Dilantin

Submitted by Perla78 on Sun, 2006-09-24 - 06:52
Hi Woody, I was on Dilantin for 14 years and started taking lamicta 3 months ago.At this time Im off from Dilantin and feel much better but still in the process of getting on the correct dosage of lamictal .Meds work differently on everyone. good luck!

Re: Adding Lamictal while taking Dilantin

Submitted by scorpio on Tue, 2006-09-26 - 08:16
Woody, since you ask, about ten years ago I was taking a combination of Clonazepam (Rivotril) 2mg/d and Phenytoin (Dilantin/Epanutin) 400mg/d but was still having petit mal-type seizures every 5/6 days - though they were really a mild form of complex-partial TLE. Lamictal (Lamotrigine) had recently been licensed (in the UK) and seemed to be quite successful for my form of epi. My consultant allowed me to try it and over 5 months I was weaned off the Clonazepam while the Lamictal was increased to 400mg/d. The epi was better: fewer seizures, but still no overall control. However, some side-effects of Lamictal were becoming apparent (giddiness in my case). Suspicious that the Phenytoin was having only a marginal influence on my epi I also did some research on it. Inter alia, I learnt about that drug’s effect on the body’s metabolic rate and how the latter related to the average serum levels/half-life of any other AEDs taken alongside the Phenytoin (it reduces them). I decided to see what happened if I unwound the Phenytoin I was taking, which I did, over a period of 4 months. Halfway through this process I realised that a fortnight had passed and I had not had any type of seizure: the first time this had happened in 20 odd years……… Finally off the Phenytoin, 6 months went by (taking 400mg/d Lamictal only) and the seizures had still not returned. So I decided to reduce the Lamictal too, which I did, incrementally, over 12 weeks or so, eventually reaching 200 mg/d - Lamictal is, I believe, one of those drugs whose dosage needs to be changed particularly slowly as side-effects become more apparent if it is not. Down to 200mg/d, I started to have the occasional odd ‘feeling’, a form of petit mal I suppose, lasting only a few seconds (they feel like the sort of ‘irritation’ you might have if something accidentally falls off your desk, and you have to pick it up). So I decided to stop there, at 200mg/d. Only once since then have ‘real’ seizures broken through, when I had a series of bad ones, if not completely disabling - they nearly were, over 2 days. However, I know what caused them, even if I do not understand why: a combination of tiredness, constipation, and lack of water – the latter in particular – seems to be a necessary condition for the onset of seizures, for me. In this case they followed a night flight. As a consequence of the above, I do not allow myself to become too dried out and one of the first things I do if I find any hint of a seizure sequence approaching is to drink half a litre of water or so. And that normally does the trick though, exceptionally, I will also take an extra 50mg of Lamictal, there and then. However, I find the latter necessary only once every few months or so. Everyone is different and your experience with Lamictal will no doubt be too. I hope you find something that works: I have had epi all my 53 years and Lamictal is the only drug that has controlled my epi. At any rate it will be good for you to be off the Phenytoin/Dilantin, with all its nasty side-effects – if such is possible. Chris

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