Re: medication toxicity?? - Kieu

[Guest guest]

The main problems that seem to lead to seizures increasing rather than

decreasing on the diet from what I have gathered are either from a) an

underlying (so undiagnosed) metabolic problem - usually along fatty

oxidation lines, but this one is pretty rare...oh, that includes carnitine

deficiency btw.. a food intolerance/allergy of some sort (like for example

if not a lot of dairy was consumed prior to the diet, and a heap of say

cream is then eaten to boost the fat content of a keto meal, this can

trigger a response, this happened with cheese with my son, but there were

other signs in him as well, mainly spots appearing on his face) c) excess

ketosis - usually the problem here is the kiddie going too acidotic which

can cause seizures, but also a 'ketone' toxicity with or without

accompanying excess acidity has been described as well, d) hypoglycemia and

e) most commonly - med toxicity.

The state of ketosis can alter the way the meds are metabolised, so even

if blood levels show no change, how they affect the child can still differ.

There is brief mention made of this in Dr Freeman's book, outlining the

reason why - to do with the protein binding mechanism of the AEDs, or

something along those lines (sorry to be so vague - I don't have my book

handy..., and if this does happen, it seems the higher the ketones, the

more impact the med will have. Like when was very toxic, he was prone

to toxicity induced seizures after his evening meds - as they peaked his

ketones levels were at their highest, result was overload and seizures. But

after a while he got back into seizure mode fullstop (seizures begetting

more seizures, and then the pattern to the seizures was less definitive).

The only way to combat this with him was to do some rapid med weans.

There doesn't seem to be any one AED that doesn't have the potential to

turn toxic, but the benzos and barbiturates are the ones more commonly

documented to do this.

Personally, we have had trouble with lamictal, depakote and the

benzodiazepines (klonipin is another in the benzodiazepine class of meds) in

particular as far as toxicity goes.

He is now on a low dose of depakote (500 mgs, 18 mgs per kg, and we now

split it 3 times in a 24 hr period, meaning having to give him a dose in the

night, but this seems the only way he can handle the total dose without

seeing toxicity in him as the doses peak) as well as low dose topomax (150

mgs, so 5.5 mgs per kg). Touch wood - we have finally lost the toxicity that

plagued him for the first 2 yrs of being on the diet, and he has been

seizure free on this regime for nearly 4 mths now.

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

> has been on the diet for 3 weeks now. Before starting the

> diet, he was having 8 to 12 seizures per day. Now he is having over

> 30+. His urine ketone level vary from small to large throughout the

> day. Blood sugar are between 75 to 93 using one touch ultra

> glucometer, which has a 1 to 20% variances from hospital glucometer.

> Could his increase seizure acivity due to medication toxicity? He

> is on Klonopin 1.725 mg/day; Lamictal on 50mg/day. Has anyone heard

> of med toxicity with klonopin or lamictal??

> He is about 19 lbs and is 9months old.

> I had posed this question to his neurologist and he recommeds we

> stop the diet. I am really reluctant to stop the diet because we

> see this diet as our last hope. Giving up this diet is like giving

> up any hope that my son will ever get better.

>

> greatly appreciate your response in advance.

> -kieu (kyle's mom).