Discussing changing medications or time medication is taken.

tomke001,It sounds like you are doing a good job keeping record of your medications, dosages, times when you take them, and the seizures.  I do the same thing and it has provided me with some answers the doctors could not.  It also helps you take better control of your treatment instead of letting your doctor guess at what's causing your problems and what he/she should do. Keep it up.Of course it is great to stick to a regular schedule when taking the meds, but if Lamictal is an effective drug for your seizures I wouldn't think that missing your medication by an hour should have any significant effect on seizures.  I looked it up and Lamictal has a half life of 29 hours which means it take that long for the concentration or amount of drug in the body to be reduced by one half.  When you tell your doctor about this he or she will likely suggest an increase in dosage to see if that helps.  Read the literature that comes with the Lamictal you get from your pharmacist.  It gives instructions on what to do if you miss a dose.  I haven't taken Lamictal for years but I'm pretty sure it would tell you that if you miss a dose you are to take it as soon as possible.  I still take Dilantin for my seizures.  It has a pretty long half life (average 14 hrs) and my doctor once told me that I could get away with taking it twice or even once a day.  But I told her I wanted to continue to taking it three times a day, that way if I do miss a dose (which rarely happens) I would be sure to realize it and take it along with my next dose.I wouldn't be afraid to try taking the Lamictal three times a day.  Just continue to keep track and let your doctor know of the results.  Mike

Hi Mike thank you for replying. I’ve been in touch with my epilepsy nurse and ahe will make me an appointment as soon as she can.When she looked up my records I haven’t see her for a year and she thought I was seizure free. However I did have one in March but did not report it to her. When I look at the pattern I can go 7-8 months without one and then have half a dozen within a week. So I will mention this to her as it may be that my medication needs altering a bit.I’m hoping to get sorted soon Thank you once again 

You need to know your Lamictal levels and when peak plasma hits your blood stream.  I take lamotrigine ER, extended release. As such, I do not have worry about peak plasma anymore. First, please read the pharmaceutical insert, line by line.  The actual amount of hours your levels fluctuate is dependent on the half life of the AED, so read that pharmaceutical insert!Second, most doctors take a blood test at the appointment and that's that.  So get a few blood tests at different times of the day, remember to take the drug at different time intervals when you do this.  Do this over a period of a few weeks, this can't be done on one day or in one week.  You you will be paying out of pocket, insurance only gives you one test per x days.  As for missing a dose, by knowing your lamotrigine levels, you will know the time duration of the high and low of the levels.  Remember if you're drinking alcohol, the levels are shot, drinking alcohol is the worst thing you can do on AED's.  I know, it is so hard to say "No" to a good glass of red wine. Ideally, an AED level in your blood stream should be a straight flat line. When I accidentally skip a dose of lamotrigine, (God forbid, but it happens...) I get a seizure a day later.  A focal with absence and amnesia. I have no memory for about 20 minutes, it can be scary.  I have come too not knowing where I am.