Lamictal starting blood level?

Posted by minajo @minajo, May 18 12:32pm

Hello all.
My ongoing story with my 48 yr old daughter, autism and epilepsy, nonverbal.. she just finished titration off Zonisamide.. even her kidney values have gone back to normal, abdominal issues leading to impaction and hospitalization much better! I told epileptologist for months Zonisamide wrong bit she disagreed(:
So now Lamictal, went from 25-100 over 8 weeks, some issues with headaches, behavior, affect , but yesterday first blood serum at 2.9( normal 2.5-15)
So low end of normal, no seizures to date but only two weeks at 100 mg in morning.. Zonisamide was pm but now should we do Lamictal at night, maybe twice a day? its a XR but can cause insomnia..
She takes melatonin at night, also on Seroquel 150 a day and buspar 30 but sleep disorders common in autism .. forever with her but her mornings on Lamictal seems to !cause behavior, she's been doing little, bit lethargic so any opinions, advice appreciated as she is nonverbal so trying to figure her out! Thank you all!!

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@minajo
Because Lamictal is extended release it shouldn't need to be taken more than once a day. Always take it at the same time. I have always taken my seizure meds whether immediate or time released once a day (with doctors permission) because of memory issues.
Blessings,
Jake

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@jakedduck1

@minajo
Because Lamictal is extended release it shouldn't need to be taken more than once a day. Always take it at the same time. I have always taken my seizure meds whether immediate or time released once a day (with doctors permission) because of memory issues.
Blessings,
Jake

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Thank you, yes i see..
Just trying to figure if it will cause insomnia given in pm as another person on this site stated.. not good for autism.. but seems to cause lethargy, no interest in doing daily activities as its given in morning now
Also for bi polar so hoping things change soon..
Big decision to change even time of day !
Thanks..

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@minajo
Insomnia is a potential side effect and not good for Epilepsy either. But who's to say it won't cause drowsiness and aid in sleep instead.
It didn't seem to make any difference if I took my seizure meds, although not Lamictal at least not that I remember at night or during the day. My level of fatigue was the same.
Considering the combination of medications she's taking it seems some degree of fatigue is inevitable. What does the doctor recommend?
Jake

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@minajo
I agree with Jake when she says that XR should be taken just once a day.
Lamictal has caused much insomnia to me and this is the reason why I could not continue with this medication. Because of that, my doctor at that time, has changed the intake of Lamictal from the evening to the morning to see if my sleep would improve. It didn't. Insomnia is one of the most common side effects of this drug. Did your daughter have insomnia problems before starting Lamictal?
Chris (@santosha)

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I take 400mg Lamictal at bedtime and 600 mg Trileptal, 300 mg in AM and 300 mg at bedtime and experienced both fatigue and sleep disturbance for several months until my body adjusted. I stayed with it because my seizures were finally under controlled after years trying to find the right mix of meds.

Everyone reacts to meds differently, there's no way to know what works until you try it, talk to your doctor, maybe half and half will help. Be careful making sudden change, it might be best to take the second half at dinner and gradually work towards bedtime.

I've found taking my meds with food, breakfast in AM, snack at PM helped.

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Hi !, Well my first and foremost comment is never take more or less seizure meds than has been prescribed, now following on never wait to take your seizure meds even if it is only a few hours before your next dose is due. NOW I say this only based on my neurologist who is an epileptologist has scolded me so many times for procrastinating while trying to think if is it too close to taking one dose just ..... apart; he explained it to me this way Lamictal is naturally a slow releasing drug so even taken close together one time is not going to harm you. Again ANYONE out there who needs to correct me do so. Lamictal XR is as many have said is extended release so I would say take it when it is the easiest to take/ remember. I take Lamictal and Zonisamide, I've taken upward of Lamictal 250mg twice a day and Zonisamide 300mg twice a day. They ( the internists) have lowered the Lamictal to 100mg but over the last few months I have started having headaches (?) except for my issues with the doctors here, nothing has ever seemed better or worse. What amazed me was the Kidney and digestive problems from Zonisamide? I never heard that I have both and chronic kidney disease if this is common could changing away help my kidney also my endocrinologist & nephrologist would be interested not as clinical proof but perhaps as a reason to check to see if any of their patients who are epileptics also take Zonisamide and have poor A1c, Glucose and Creatinine levels, well new possibilities, you sure helped me I hope I "said" something that help. Take Care

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