Hi Donna

been missing you...

how are things going with Derrick, any better?

how have you been? drop us a note when you can.

~ waves ~

Everyone


Hi, Derrick's dilantin is very high. So he is off it right now.

We go again tomorrow in the morning to get a status draw again.

SO we will see what it is like. He had another seizure yesterday
at school.

Dad had to go get him. He is now yelling at me right now. Guessing
he is off again.

Hmmm, we will see.

Oh well I'm watching. Hubby got laid off again Monday. ANd I'm
working again, school is in full session it seems.

Donna

Dear Donna

thanks for the update.

hmmmm. i'm surprised the Zonegran level didn't dip then... i wonder if it maybe did a little, even if not technically below the therapeutic level.... because i'd expect the phenytoin (Dilantin) to induce Zonegran metabolism via the CYP3a4/5 pathways.

i am wondering now if maybe the Zonegran was never the problem then... maybe the problem was the Dilantin being too high. Either directly or because it somewhat lowered the Zonegran.

glad he will be doing another draw.

i am sorry. this sounds so hard on both of you.

sorry about your hubby. i hope you are enjoying work. i recall that you love what you do.

please keep checking in with us, when you can.

~ waves ~

Thanks Waves

Oh I check in usually daily. I just don't always comment.

Derrick's dilantin is down to 24.5 today. But I'm not sure they
want us to go back on tonight. 200 evening 200 in the mornings.


Its still high. So I'm not sure whether we should wait one more
evening to start back on.


What do you think. My husband suggested waiting. I had already
thought of it.

We had already know about 2 months ago, the dilantin was very
low. So now its high. This one is going to be watched now.
I'm wondering if the zonegran brand name, and the seroquel
going off made this change.

The zonegran is just barely theurapeutic. So I'm not even sure
I want him left on this one.

Donna

Dear Donna,

sorry hi i just woke up...

if you're still deciding... i would wait. and maybe call the doc in the morning. sounds like he was expecting it to come down to where it needs to be by now, and if that isn't the case, you should call him and see how he wants you to go forward.

You won't know if the Zonegran is helping or not until the Dilantin level comes down.

Seroquel and Zonegran do not affect each other, and do not affect Dilantin.

Conversely, Dilantin affects BOTH Seroquel and Zonegran, increasing clearance of both.

Seroquel is not a seizure drug - in fact, it can even cause increased szs esp if one is susceptible - all antipsychotics lower the sz threshold to varying degrees. When the Dilantin was low, the Seroquel might have got too high. That probably didn't happen overnight, so it's not likely to have caused big problems. Nonetheless, it complicates the picture.

Currently with the Dilantin too high, the Zonegran might be lower than it needs to be, even if it is still within the therapeutic window (you said barely). The Zonegran level might go up more, when the Dilantin comes down.

Dilantin is a messy drug, interaction-wise. It affects bunches of hepatic enzymes and consequently bunches of other drugs. Good idea to keep an eye on it.

Wait until the Dilantin level is where it should be. At that point, make dose adjustments to the other meds if necessary. Only then will you be able to evaluate if the other drugs are helpful.

~ waves ~

Waves

Thanks i knew you would know this answer.

It was one of the doctor's in the practice saying to go back
on the medicine.

I have to ask him if he went back on this morning or not.

You can see I'm not to concerned at this point. I personally
see a change in him. So I like to watch more.

So I think tonight is a good choice because I can watch tomorrow
and then have a idea.

Donna

Hi Donna!

Hope you are doing okay. Sounds like you are going thru a lot right now. My son takes meds too. It is hard finding the right cocktail. It took us a while to find our boy the right meds. Understand so much how difficult it is.

I have taken Seroquel XR. My pdoc told me when he put me on it that it is better than the regular Seroquel because it is a) the extended release and stays in the system longer b) doesn't have that bad of weight gain tendencies as the regular Seroquel (I didn't gain any weight with it) c) What Bizi mentioned about the larger dose: I was taking 300 mgs. It made a difference for me with the higher dosage. However I like the Geodon better than the Seroquel XR better. It just works better. Some people like Abilify better than either of those two antipsychotics. All meds work different for everyone. I have taken all three. They all worked different for me. I know people who have taken all three too- and they have worked well for various people in different ways. It just depends on the person/med/their body's response to the drug.

Hang in there!!

Hugs!!

Coffeegirl

I have had a busy week or two. And am doing okay.

We are having a good between hot and cool weather.

Donna