Re: Lamictal-

[Guest guest]

Dear ,

Thank you for all the info! I'll be sure to keep it handy when we

begin the wean.

Our daughter was briefly on Depakote, too, just over a year ago. Our

pediatrician told us she was almost at toxic levels, so that's when

we started decreasing the Depakote and adding the Lamictal. But our

hope has always been to have her on no meds, since none have worked

for her anyway, and hopefully that time is soon!

Tammy

> Hi Tammy,

> That is a fairly large dose isn't it, and is actually where

had got to as well with that med, he was nearly 5 when we

started weaning it. It was far too much for him to cope with, this I

know, but he was on 2 other meds (including depakote which

potentiated the lamictal) at the same time, so probably a bit

different.

> We took more off the top than we normally would have after he

started the diet because of the toxicity factor, but from memory I

think it was 2 separate reductions within 7 days (one of 50 and one

of 25) to take him down to 125 mgs - but that was in a hospital

setting, so a lot different to what we would have done at home.

> We did the rest of the wean over the whole of the next year,

actually it took 18 mths I think? That long wean was because he was

on the 2 other meds as well though, and we had to tweak one, then go

back and reduce another and so on.

> We did a couple of 25 mg reductions after we got home over the

next few mths, then slowed it down to bring it in line with 10%

decremental decreases, (usually once every 2-3 weeks) which was

fairly do-able because of the 5 mg pills available.

> He had withdrawal fallout with just about every decrease, the

large one in hospital was kinda hard to tell because he was already

having a lot of seizures again at that point, but once we got daytime

control back, we were able to easily tell what were withdrawal

seizures.

> They used to come like clockwork actually, one or two drop

attacks on either day 3, 4 or 5 following each reduction - always

between about 3 and 5 pm. Not sure why this timing was in the day, it

happened at that time whether we had taken off the morn or evening

dose, which I aways found a bit strange.

> Once down to the lower doses (say below 50 mg total) the fallout

used to last a bit longer, sometimes some 'off' behaviour that was

prob sub clinical activity lasting up to about 2 weeks at a time.

> The lamictal with was always a bit dicey, we are pretty

sure it was one that had aggravated his myoclonic seizures, he has a

predominantly myoclonic epilepsy syndrome (MAE) and when used in

these types of syndromes, it can def have that effect. Having said

that, it is one that has been a successful med for some other MAE

children that I know of, so obviously this is not always the case.

> It is because of the myo aspect that we chose the lamictal to

reduce first out of the 3 meds he was on, as the seizures that

returned in the day after his initial seizure free response were all

myoclonic, either myoclonic astatic drops or myo twitching of

extremities. We are pretty sure that the ketosis (protein binding

mechanism of many meds is often altered) boosted the lamictal up and

induced the myos that had initially been controlled on the diet.

> He had other effects during reducing as well, like a lot of the

side effects that came with lamictal with him seemed to be enhanced,

especially sleep and behavioural disturbances.

> If you are in no real hurry because of toxicity like we were, I

think if it were me I would maybe do 25 mg reductions perhaps every 2

weeks until you are down to mebbe 125 mgs, then slow it down to 12.5

mg (half a 25 mg pill) reductions to try and keep it to 10%

decremental weaning if possible, depending on how he goes of course.

Then use the 5 mg pills to do 10 mg, 5 g and 2.5 mg reductions and so

on till it has all gone.

> Our Neuro is one who doesn't usually do decremental weaning, he

usually does step wise, like he would have said reduce by 25 mgs

every couple of weeks till it was all gone, but we have found this

method doesn't work with , as the percentage reduction actually

increases the lower down you go, so more of a shock to the system I

think.

> Good luck, let me know if I can help with anything else,

>

>

> ----- Original Message -----

> From: tkkoski

>

>

>

> ,

> Hi. I'm eavesdropping from the atkins board and noticed your

comment

> about weaning from Lamictal. We've been on the atkins diet 2

months

> now with major seizure reduction (not seizure-free), but our 6

year

> old is still on 100 mg of Lamictal, twice a day. How do the

doctors

> usually do the weaning, and what kind of danger withdrawal

symptoms

> do we look for?

> Thank you so much!

> Tammy

>

>

>

>

>

>