[Cedar]

I have been told by my epileptologist for some time now 2 years about. That there is no point in doin blood test for my trileptal or Keppra given I am taking low amounts. As they would never be at the norm theuraputic levels.

So then I start to have a lot more seizures this October-November. So my Dr. said let us increase the trileptal. I said I want blood test first.Finally it was agreed.

Te results came in today that trileptal was at 10 and keppra was at 3.8
So now I am increasing the trileptal. Yet I am curious why she did not test for trileptal way sooner. So confusing. I had to go through a huge increase of seizures first. Does not seem right. MY body has taken the toll for her not doing test sooner.

Why is it they are so caught up on therapeutic levels rather than finding each persons stable level and working with that.
I know my rather sensitive body, needs less but would have liked it if she would just test every 6 months. guess I will be demanding it from now on.
Thanks for listening.

[Porkette]

Hi Cedar.
One thing that's very important for you to do is to stay away from grapefruit and grapefruit juice while on trileptal because the enzymes in the fruit can mess up the trileptal just like it does with tegretol.
Some Drs. don't even pay attention to the side effects of AED's and how they interact with each other. I've often asked my pharmacist questions because my neuros don't know much about the AED's like a pharmacist does.
Each person is different but a lot of Drs. are watching the theraputic level of meds to be sure it doesn't become toxic and also if the drug level gets to high it can cause more sz. for some people. Here's wishing you well and May God Bless You!

Sue

[Tattoo]

It seems to me that your doc may have been trying to find that lowest dose that fits your system and case. Too much med is not good either as we all know and also causes more side effects which decreases quality of life. When you reacted to the level by having a seizure, that told you and her that the level was not therapeutic and needed to be adjusted. I know of no other ways to determine if a med is therapeutic other than using efficacy/ effectiveness or by using the stated blood level range that was derived at by using the levels where seizure reduction occurred for that huge group of people in the clinical trials. That won't necessarily be what is best for me though. I have taken Keppra since early in 1999 and have never once had a blood level done. I did have Tegretol levels done when I took it, and I think Trileptal is related. My doc now really doesn't mention changing my dose even if I have auras and she may should but she does listen to me. I will suggest and she works with me. At least you do know that the level of Trileptal you were at was too low for you, and you can adjust it upward with as few side effects possible. If you begin to have mor side effects, she will use what you tell her to adjust it again possibly. That keeps your dosage as tight and as close to your own specific needs as possible at that point in time. Do you have auras to let you know sooner? Tattoo