When is comes to medication, all my neurologists and I repeat the same conversation. Some may have different methods, but this example is the typical talk track.
ME: I had a breakthrough seizure in April.
DOC: We will start you on Keppra XR at 500mg at bedtime, as we think this is an effective anti-convulsant with the least amount of side-effects.
ME: I had another nocturnal seizure in August.
DOC: Ok, lets increase your dosage from 500mg to 1000mg in Keppra XR.
ME: I had another seizure……
DOC: Ok, we will increase your dosage from 1000mg to 1500mg of Keppra XR.
ME: I had another seizure and I feel like they get triggered a lot by stress and anxiety. My anxiety has definitely increased more than usual, especially when I started taking Keppra and I know that’s a popular side effect.
DOC: I don’t want to add an anxiety medication to combat the Keppra side effect. So lets slowly decrease your Keppra XR dosage and introduce you to Vimpat at 50mg. These 2 combinations work well together.
ME: I had ANOTHER SEIZURE.
DOC: Ok, increase Vimpat dosage to 100mg, but decrease Keppra XR to 1000mg.
ME: OMFG, I had ANOTHER F****** SEIZURE _ WHAT IS GOING ON
DOC: Increase Vimpat dosage to 200mg, Keppra XR still at 1000mg. (my doc and I are stumped on why Keppra XR doesn’t work for me, but I am beginning to realize that this disorder is about maintaining medication. It doesn’t sound right to me)
I’ve been on Vimpat (200mg) and Keppra(1000mg) for a couple months and they do work well together for me. I still have really bad anxiety, but I am trying fix that issue the natural way.
The one night I did have a nocturnal seizure was when I had to wait 2 days for the insurance to approve. I had to miss a night’s dose of Vimpat and take the Keppra by itself and guess what, I had a nocturnal seizure because of the missing medication. Thanks Insurance!
Meanwhile, now I am experiencing “awake” partial seizures and that is a HUGE change up in my diagnosis. This happened on Christmas day. That REALLY sucked. So obviously since now I have these new types of seizures….just literally the same repeated conversion I showed you earlier in this post. Something like this….
ME: So Doc, instead of these nocturnal seizures, I experienced seizures/convulsions when I’m awake!
DOC: Lets increase the Vimpat to 250mg, but keep the Keppra the same because we are going to introduce a new medication for you – Lacmictal and wing you off the Keppra
And the trial and error of Meds continue!