Depakote and Trileptal interactions

Utahmom

My son has taken Depakote since he was around 5 years old. When the dosage was too high he would get really mean and lash out without much of any provocation. When the dosage was lower, he did not have any seizures and he was not mean.

However, he is now 17 and just started having seizures again - and so we have had to up his dosage. I noticed he is a little more short-tempered but not overly so when he was little. However, his memory seems to be worse on the higher dosage and I am thinking of checking on getting him on a different medication - but wary of possible seizures when trying to switch to something new.

Utahmom

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Mother of 17 year old son, Jared, born with Hydrocephalus and takes Depakote for seizures.

firehorse

Thanks for the reply Utahmom. Did you son ever take a second drug, or was he on Depakote monotherapy the whole time? I guess I'm trying to figure out how much is the two drugs interacting, and how much is just the D alone.

The anger and fatigue come and go throughout the day. Sometimes he's fine - energetic and talkative. Then he'll just crash, much more deeply and quickly than just a normal tired kid.

Thanks for sharing your experiences.

Utahmom

He was on tegretol to begin with but that wasn't working. I can't remember if he was on both drugs at the same time when we were switching to tegretol, but I imagine we had to come off one drug slowly while going on the other.

The problem was that my son's depakote level was on the low size and the doctor thought it should be higher - but when the dosage increased, he got mean and would lash out with very little provocation. So, we lowered the dosage back down and he didn't have seizures, but he was on the low end of the recommended level.

Utahmom

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Mother of 17 year old son, Jared, born with Hydrocephalus and takes Depakote for seizures.

buliem

Hi Firehose,
You might want to ask the neuro about Keppra. My 10 year-old son takes 1000 mg of this per day along with 1250 mg of depakote. Since reaching his current level of Keppra he is seizure free. Five months tommorow! It does have some side effects (behavioral mostly) but it doesn't interfer with other meds. It won't decrease depakotes effectiveness for example. It is indicated for partial seizures but some docs will perscribe it for generalized seizures like my son's.

Patrick was a zombie on 1500 mg of depakote and was still having grand mals. I really hate depakote but his neuro seems to think this is the best route. Patrick never had a grand mal (tonic clonic) until his depakote dosage went over 1000 mg a day, just absence. Sometimes I think the higher dose of depakote caused them. Who knows?

I know it is very hard to deal with seizures and the side-effects of drugs. My son is really different since being placed on these drugs (tired, spacey and inattentive) but I can't have him seizing daily. We just take it one day at a time.

Good luck to you and your nephew.

Julie

firehorse

Thank you both for your responses. We are going to see how he does once he's completely off the trileptal and on depakote only. My brother-in-law is a neuro and he mentioned keppra, but agreed that you have to see what you get with depakote alone before you even consider adding or switching again.

I'm frustrated that our current neuro went with D as the second drug after the trileptal didn't work. Some studies have shown that your chances of controlling epilepsy decrease dramatically after the second drug fails. IOW, the first two drugs you try may be the most important decision you make when treating epilepsy. Given the low side effects I thought trileptal was a good first choice. But I really really wish that we had gone to keppra or lamictal for the second drug.

The biggest frustration is the reason we are still with this neuro is that there is a lawsuit pending over malpractice in my nephew's delivery causing the brain damage, CP and E, and we can't switch neuros until that is settled. His current neuro is good, but she's not GREAT, you know? The second opinion we got from a very prominent neuro/E doc said he would have gone with keppra or lamictal over D, and my brother-in-law said the same thing. UGH.

buliem, I'm sorry that your son had daily seizures. As I said above, Nick's were only once every few weeks on trileptal and now weekly during the trileptal weaning/depakote switch. They are complex partial seizures, but his EEG shows generalized seizure activity.

One day at a time.