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Arbitrary lamotrigine dosage? Possibly trying to conceive soon

Mon, 08/01/2016 - 19:48
Hi , I have passed out twice in 2015. The ER doctors said it was vasovagal syncope (1 in MI unwitnessed, 1 in WA while trying to sleep, while very angry; spouse awoke). None of the classic signs of epilepsy were there. No tongue biting. No loss of continence. No family history of E. No head injuries. No post ictal headache nor muscle soreness.No Hx major illnesses. No developmental delays; graduated cum laude in biology, 3.8 gpa. I saw a neurologist in northern WA who wanted to start me on two antiepileptic drugs at the same time "just in case." And to be able to tell employers that I was "managing" or treating my "epilepsy." -- C.Y.A.! I said no. MRI normal, EEG normal. Cardiology normal. 8 months later I was seizure/episode free and able to get into in-hospital multiple-day video EEG. Normal. The epileptologists at the hospital finally talked me into taking a medicine daily based solely on my history. We have been slowly titrating me up to 200 a.m. and 200 p.m. lamotrigine. I have been late several times at taking my dosage, sometimes I remember 3 hours later (after turning my alarm off and forgetting to do it). If some people get by on Lower doses of Lamotrigine then isn't it arbitrary to put me on 400 per day Straight Out The Gate? There is no way to tell if it is working since my seizures are infrequent and not proven. I'm 36, 5'7 and 146lbs. Im very active, do yoga and group exercise 4-5x a week. Lately we've been considering conceiving. And I would want to breastfeed-- not while taking any drug though! Help! I've only been on lamotrigine 7 wks, not full dose yet. I am ten months episode-free. What should I do?

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