I've been on 250mg 3x/day.  I had been doing well until August when I started getting the bad simple partial szs, the kind that lead to the partial complex.  I have had no side-effects on Lamictal and it has been one of the best meds I've been on, and now this!  I also have the VNS which helped my simple partials.  I literally lived in them.  I could not count them, it was like counting how many times you're happy during the day - you can't.  Now I don't live in them.  I can count them - but ever since August, they have been coming very forcefully.

Dagmar

I have break through Seizures on Lamictal all the time. Lamictal has never worked well for me and everytime I bring up wanting to change meds to my Dr, my Father who drives me to my Dr's appts. because I can't drive has a fit, last time I checked, I'm the one with Epilepsy. My seizures are not well controlled and as a known side effect of Lamictal, I am losing my hair. I want to change meds period.

I don't know if Lamictal is one of these drugs but sometimes an AED can lose its effectiveness.  For my daughter, Lamictal did cause an increase in seizures.  But it's hard to say if this is the case for you. 

Another thing that can lower the seizure threshold are other medications, whether they may be prescribed or over the counter.  Even some nutritional supplements can wreck havoc on seizure control.

Stress and lack of sleep are definitely factors for seizure breakthrough.  If you can document this with the previous seizures that you've had then you might be on the right track.

If you can't find a common denominator for these increase in seizures then I think it wouldn't be unwise to consider adding another AED to the regimen or replacing the Lamictal altogether.

And...one piece of advice.  If you can stay on the name brand medication for seizure control, do it.  There have been so many instances of seizure breakthrough while taking the generics.

~Karen

I too am on Lamictal and have been for about 3-4 years.  I experienced the same type of issue, however it was related to another medication, Zonegran.  My history of epilepsy is much like yours in that mine started in my mid-twenties with no prior history or family history of epilepsy.  My neurologist started me on Zonegran and my seizures seemed to have been controlled at first, but who really knew since I had my first seizure at 24 and my second at 26.  I then began to have seizures more frequently.  Like your neuro, mine was quick to increase the dosage which actually began to increase the frequency and severity of my seizures.  I spoke to several physicians regarding my neurologists desire to increase the dosage even though my seizures were increasing in frequency and was told by all that the common practice was to keep increasing the dosage until one is maxed out on the drug and then if the medication is still not effective to either add another one or start another one and taper off the one that is ineffective.  Fortunately for me, my neurologist gave up his practice to focus solely on hospitalized patients which made me search for a new physician.  My new neurologist started me on lamictal and stopped my zonegran.  My seizures decreased rapidly after stopping the zonegran.  So, long story short, I think that increasing or decreasing the dosage of your meds can equally increase your frequency and severity of seizures.  Interestingly enough.  I began taking the generic form of Lamictal and have also noticed an increase in the frequency of my seizures.  I am seeing my neurologist in the next few weeks and will bring up this issue with her.  I hope my ramblings help you.

Tod Morrison RN, BSN