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Medical Forum / Diseases and Disorders / Epilepsy / August 2004Lamictal Schedule
Good Evening All, My 5 year old daughter was diagnosed with Primary Generalized Absence Seizures about 6 months ago. She has been on Lamictal for 6 months now. She ramped up slowly to a doseage of 50mg twice a day (100mg total) and achieved complete seizure control for about 3 months. She went through a growth spurt and gained some height and weight and the seizures started again. The Ped. Neuro increased her doseage to 75mg twice a day (150mg total) and we regained almost complete control for the last 2 months or so. We know one of her main triggers is over tiredness and an occasional seizure will happen when she is overtired, but a few more are beginning to show up now even when she isn't that tired. I was wondering if the timing of giving her the medication could affect the seizures. We have been trying to space them out 12 hours apart to make them even, but I have been wondering if the increased physical activity in the day, and obviously less activity when asleep could cause the meds to work through her system quicker in the day. Would a better schedule be 8:00am for the first doseage of the day and say 5:00pm or 6:00pm for the evening doseage? Any comments, suggestions, advice would be welcome. Zeeke hello zeeke, from what i know and have experienced increased physical avtivity shouln't make a difference for the lamictal. as long as your daughter is taking it regularyly, the bloodlevel should be constant. the decomposition of lamictal is quickend, if it is taken with some types of other meds like paracetamol, carbamazepine and several others (i think the instruction leaflet gives more details). perhaps there is also some food that influences the lamictal, you better ask the doctor next time you see him - or maybe someone here knows more about it? there is also the chance, that lamictal is not yet the ideal medication or the dose is not yet high enough, though i doubt the latter, because 100mg should be quite enough for a 5 year old. raist The rate at which the liver breaks down the drug might vary throughout the day which could alter the blood levels of the drug even though you're giving the same dose. Maybe your doctor (or pharmacist) knows (or could find out) when the liver is most active for this drug and alter the schedule accordingly. All you might need is a slight change in the seizure threshold for them to start/stop appearing again. I don't know if this could be affecting your daughter's seizures but it's something to think about. It's the kind of thing pharmacologists (drug researchers) are interested in anyway. > Good Evening All, > [quoted text clipped - 18 lines] > > Zeeke > My 5 year old daughter was diagnosed with Primary Generalized Absence > Seizures about 6 months ago. She has been on Lamictal for 6 months now. [quoted text clipped - 16 lines] > > Zeeke These sound like questions for your pediatric neurologist, though there is good info at the various links here: http://www.lamictal.com/epilepsy . I have just started on it myself, and as you probably know, you need to watch for lymph node changes and *particularly* for rashes (more likely to occur in children, which can be fatal), and know that Lamictal and valproic acid (Depakine, Depakote, Epilim) interact. Since seizures can also happen at night, and since activity may not affect blood trough levels, a 12 hour schedule may be best. Also, it may be more important than it would seem that the dose times be maintained *exactly* and regularly for best control, even with time-release medications (my neurologist friend emphasized this when putting me on Depakote ER, illogical as it may seem - but he insists that he can gain control with patients who fail with other neurologists, just by carefully controlling the dose timing [in addition to amount]). In all of the above, recognize that I am not a doctor. Good luck with gaining control over the seizures. --DR |
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