Re: medication toxicity and meals?? - Donna - benzos etc

[Guest guest]

Yes, the benzodiazepines were the most obvious ones though - I could set

my watch for the seizure after 's oral diazepam and keto lunch were

given together.

The very first day I split them up, we waited for the usual 1.32 pm one -

and it didn't come!

I had been researching back then about the rebound effect that can occur

if benzodiazepines are given with a fatty meal (er - warning bells rang

obviously considering a keto meal content....) - I had asked our hospital

pharmacist to contact the author of a paper I had found where caution was

mentioned if the 2 were given together (from a dentistry anaethetist journal

paper - had recently been on a midaz infusion and I had been keying

in various search words and that had come up).

He managed to contact the anaethetist concerned, (no easy task as the

search for him was from here in NZ all the way to the US) but he was unable

to cite his original source, so we never managed to get a definite 'medical'

answer as to why....

My theory was that all benzodiazepines are fat soluble, so when given with

a lot of caloric fat content, there would be a big 'boost' of the med going

through initially, meaning toxicity as the dose peaked, but also a lower

than usual trough before the next dose was due, as the med had been more

rapidly absorbed than it was supposed to be when given with fat. With a

benzo, where it is especially important to keep the blood levels as even as

possible due to the potential for toxicity and also inter-dose withdrawal

seizures at the other end of the scale, this seemed to me like a dangerous

mix.

I emailed a lot of folk back then asking if this was a medical

possibility, cos if so, then warning of this should be given to parents who

were starting their kiddies on the diet with a benzo as part of their med

cocktail, but I didn't get a definite affirmative reply from any of them.

Quite a few 'yes it is possible, but there are no studies to back this up'

blah blah type replies, which is what our pharmacist had initially answered

as well. His advice to me in the end was to follow my own instinct and judge

according to 's response - which I did, and it seemed to work for him.

Remember though, that he was borderline toxic most of the time he was on

these meds, they were just bad, bad AEDs for him fullstop. And any of the

measures I took like changing the dose, times, etc only seemed to last for a

short while, then back would come the wooziness, drooling, cloudiness, and

eventually, the seizures. Hence the need in the end for the cold turkey

removal of the benzos, it was almost like they had become an actual poison

to him, and I couldn't keep one step ahead any more of the resultant

toxicity

The depakote when at a mediocre dose used to see a similar reaction (this

is one that is stored in fat tissues as well) but more of the 'away, zoned'

probably sub clinical stuff, not pushing him to an actual clinical seizure

as regularly as the benzos did when given with keto food, more so when

ketones were higher late aft/evening with this one, as opposed to the

benzo/keto mix seizures which used to come regardless of his ketone level at

the time.

However, when 's depakote dose was boosted early last yr (bad move,

should never have been done) to 800 mgs, so at a 'toxic' dose for him, he

would have his morn dose at 9 am, drop attack would follow at 10.30 am - no

variance really ever. One weekend we went away to a hotel and as happens

when on hol, his depakote dose was late, by about half an hr - and instead

of the 10.30 am drop attacks that had crept in since that depakote hike, the

drop came at 11 am instead. Did this for 2 days in a row, same thing

happened, moved the dose back to the original time - drop was at 10.30 am.

When I showed our neuro my diary with that kind of irrefutable evidence, he

agreed that we had to reduce, which we did, and those seizures went away

too.

Bascially - med toxicity is as far as I am concerned, is highly

under-rated on the diet, be it from the med dose itself, from the

combination of ketosis and the the med, or the timing of when each one is

given, if a definite pattern of seizures arises that can tied onto meds or

meals, I think you have to experiment a bit to make sure this is the cause

then take action - either by reducing to a level that can be tolerated,

splitting the meds and meals, etc etc. Time consuming and can be a long

process, I used to write anything and everything down, even what he had been

doing prior to a seizure, cos even a high level of activity in to my

mind could have resulted in some body fat being burnt, stored benzo and

depakote released from fatty tissues - toxic - seizure.

Poss a bit single-minded, but that's me when it comes to what some of the

drugs have (unfortunately found out in hindsight most of the time) done to

him...

----- Original Message -----

> would you see seizures when giving medicine at the same time as a meal?

several times i have given medicine then 30 minutes later a seizure. would

this decrease if you spread out keto meal and meds?

[Guest guest]

Keep in mind that 's reactions to these meds were pretty extreme

though Donna, both to any of the benzos and also to the depakote - well when

on doses above 500 mgs of this one anyhow...

The splitting of the meals and meds is not something our hospital told us

to do, and from what I can gather, no one else seems to have been told this

either, but as long as it is not a med that 'needs' to be taken with meals

(like for gastric upset reasons or somehting along those lines) I think it

is worth trying, especially if you suspect a reaction after each med dose

when given with a meal.

----- Original Message -----

> wow. i had no idea! thank you thank you for your long and very

informative response!!!

[Guest guest]

Keep in mind that 's reactions to these meds were pretty extreme

though Donna, both to any of the benzos and also to the depakote - well when

on doses above 500 mgs of this one anyhow...

The splitting of the meals and meds is not something our hospital told us

to do, and from what I can gather, no one else seems to have been told this

either, but as long as it is not a med that 'needs' to be taken with meals

(like for gastric upset reasons or somehting along those lines) I think it

is worth trying, especially if you suspect a reaction after each med dose

when given with a meal.

----- Original Message -----

> wow. i had no idea! thank you thank you for your long and very

informative response!!!

[Guest guest]

Keep in mind that 's reactions to these meds were pretty extreme

though Donna, both to any of the benzos and also to the depakote - well when

on doses above 500 mgs of this one anyhow...

The splitting of the meals and meds is not something our hospital told us

to do, and from what I can gather, no one else seems to have been told this

either, but as long as it is not a med that 'needs' to be taken with meals

(like for gastric upset reasons or somehting along those lines) I think it

is worth trying, especially if you suspect a reaction after each med dose

when given with a meal.

----- Original Message -----

> wow. i had no idea! thank you thank you for your long and very

informative response!!!