Lamotrigine (Lamictal) and falls
 

Hi
I'm a new member and this is my first post.

In September 2006, after 33 years of epsiodes, I was finally given a confirmed diagnosed of E. I have been on medication for 2 years now and still remain unstable although szs have reduced. I take a range of medications for E and other conditions. The epilepsy specific ones are lamotrigine (Lamictal - 375mg) and levetiracetam (Keppra 1125mg). Recently Danazol has been added to try to reduce the catamenial szs - other things have been tried for that and failed because of adverse drug reactions.

As a side-effect of the lamotrigine, I experience falls some of which have been quite significant requiring admission to Accident & Emergency room. If the dosage is too low then my szs increase and falls decrease - if the dosage is too high the szs decrease and the falls increase. Seems a Catch-22 situation!

Has anyone else encountered this problem and if so have you resolved it?

Best wishes

Susie--
this is really something you need to address with your neurologist. If the falls are the quantity/severity of needed ER or Hospital attention, it needs to be addressed quickly. I understand that if you lower the dosage you may have more seizures, but just from your post I gather your seizures are not 100 % controlled either--hence Lamictal may not be the right medication for you. There are many, meany medications and options for treating epilepsy and seizures-- talk with your neuro about it and come up with soloution or plan of action on.

On somewhat different note, I am curious as to what make you think that the falls are solely cause by the Lamictal not caused or aggravated by any of your other meds, especially neuro meds. I am not doubting what your saying, so don't take it that way-- just throwing out some thoughts. Like you, I am on multiple meds for seizures AND other neurological issues. All meds that effect the nervous system have unique effects on the body and when you combine several of them together the chance of developing side effects--- either more extensive one you already have or new ones from the combination is much higher. I am living proof. There was a time when I was on Depakote, Keppra and Lamictal for seizures, and Elavil for nerve pain and I experienced signifigant tremors and was forced to lower the Elavil doses. After I got off Depakote, the tremors subsided greatly and I was able to increase the Elavil with no major problems. I also had some nasty reactions to medications that I probably never would have had if I weren't on multiple meds. Often times you can keep the various meds, but your dosages may have to be altered some so you can get the best help from them with the least amount of side effects. Don't discount the possibilty that the falls could be a combination of things.

So, please discuss everything with your neuro--falls can be really dangerous---and sometimes more so than seizures, so this side effect is not one to take lightly.

Good Luck !
:) L2L

Hi L2L

Many thanks for your detailed reply - it was good to hear your views and perspective on what for me is a problem with potentially conflicting solutions.

You may be surprised to learn that the conclusion about falls vs szs and their relationship to lamotrigine was from my neurologist who's a specialist epileptologist. Since I made this post I have reached a week on a lowered dosage of lamotrigine at his request (a reduction of 7%) and on Friday started to have an increase in szs - 4 over the w/e. So have reverted to the former dosage!

I'm due to see the GP (general practitioner) later this week so will have a discussion about the next steps and will take the opportunity to talk over various aspects including those which you have raised about the impact of drug combinations.

Many thanks and all the best

Hi Susie--
I didn't mean to over alarm you about the falls thing. Something I forget to mention and didn't think about at the time, was the "why" the falls may be occuring. I am not sure if you are meaning random falls with no appherent reason OR side effects that can cause falling. By cause I am meaning side effects such as ataxia, dizziness, light headedness, and a few others which, in certain situations can result in people falling, tripping etc (as an example, I was had a really bad "fall" or sorts in gymnastics class, which further resulted in a broken foot--- the fall was due to a side effect of one of my previous anti seizure meds).

My only real soloution to the ataxia, etc type problems were to either wait it (and hope it went away) or adjust my meds. I am currently experience a lot ataxia, ligh headed ness, etc on my newest med and I am choosing to "wait it out" for a few weeks to see if my body adjusts.

I know it can be very tough to balance side effects, seizure control and all of the other important quality of life issues !

Take care-- L2L

Hi L2L

I hope that you are ok - please don't be concerned - I wasn't alarmed and appreciate you sharing your views with me.

Sorry not to have replied sooner - have had some problems with extra szs having reduced the lamotrigine to counteract the falls - have reverted back to previous dose as you might expect!

Have also being going through the difficult step of dealing with my job being at risk. I have been away from work for a year now - sick pay stopped in May and a decision has to be made where to go from here. Met with the unit Director (a pathologist) and head of Human Resources and was referred back to Occupational Health (OH) specialist. I work in the UK National Health Service (NHS) ironically...

On recommendation of the OH consultant, I am applying for early retirement on ill-health grounds - if that fails I shall appeal and if the appeal is unsuccessful, then my employment contract will be terminated. All this meets the requirement of UK employment law in the circumstances of ill-health but nevertheless it's difficult to see it in a positive light at the moment.

Many close friends and colleagues who have observed my condition over the years believe I should write a book - perhaps this will be the push I need to get on with it!!

All the best

Sue