Hello jess,
Zarontin is commonly used for patients who are having absence seizures,
but it’s also used for myoclonic seizures as well. Now the thing about
lamictal is that it can control both the tonic clonic and absence, but it
is also used for patients with simple and complex partial seizures,
secondarily generalized seizures, lennox-gastaut, and juvenile myoclonic
epilepsy.
The “published” therapeutic range for Lamictal is 4 – 20. This is just a
guideline and starting point for doctors to use for their patients. It is
based upon a study of a particular group of people with epilepsy. They
average all of the results and the lower limit is set by the minimum
amount most people need to have in their bloodstream to have a therapeutic
effect (reduction in seizures). The upper limit is the maximum amount in
the bloodstream that most people can have before they start having
unacceptable side effects from the medication. Notice the keyword here is
‘most people’.
There is nothing in there that says this applies to you, nor does it apply
to everybody in the study.
Each person has their own individual therapeutic range. The lower limit is
the minimum amount that you need to have in your bloodstream to cause a
reduction in seizures, and the upper limit is the maximum amount you can
have in your bloodstream before you start having unacceptable side effects
from the medication. Notice the keyword in that is ‘you’.
Whatever that lamictal level was for you is most likely right around the
lower limit of your individual therapeutic range. BTW, I’m also on
lamictal and found out recently that the amount in my bloodstream is also
low, because I’m still having seizures but no side effects. It has reduced
the previous amounts of seizures I used to have. So I’m going to get my
neuro to increase it. Maybe you can get your doctor to do the same thing
and possible avoid having to take any additional medications. Use only one
medication whenever possible, which is monotherapy.
Who knows, your therapeutic range of lamictal may be partially above the
published number of 20. The only way you and your doctor can find out what
your limit is, is by slowly increasing the dosage amount little-by-little.
Whenever anyone starts to take medication and whenever they increase the
dosage amount, most likely there are always going to be side effects and
they’ll usually fade away once you reach the level amount your doctor
wants you to be at. If your seizures have reduced even more then that is
great. But if you finally come to a point where your seizures have come to
a halt and you are not having any side effects, then the doctor’s goal as
finally been reached. ‘No Seizures, and No Side Effects’. The doctor
should then order another blood test to know what your ideal number amount
necessary is. Once this has been done, ask the doctor what that exact
number is so you can keep track of it yourself. And besides, Lamictal
might be the only medication you need to be taking to control all of your
seizures.
I hope that this helps you and gives you some ideas about what you may
want to discuss with your doctor. Good luck.

Bruce