Discontinuing Topamax
Rick completed his taper of the Topamax yesterday. This morning being the first day that he didn’t take any Topamax. He is still taking Keppra 1500 mg bid.
He hasn’t had much of any problems with the taper until this past week.
030611 had a start in night while on Topamax 75mg bid and then was slightly seizurish the next morning
031311 had a start in the morning while on 50 mg
031811 Started Topamax 25 mg bid
032011 was very seizurish, shaking all over like nervous or cold. When in shower he made a sound like the start of a full blown seizure. Needless to say, I took him out of the shower immediately. We went on to church and he was alright.
032311 had a start while dressing before meds
032411 another start in morning before meds
032511
This morning though, before he had his morning medication, he was very jittery, twitching and having those starts. He collects saliva in him mouth a lot now and 2-3 times the ‘start’ caused him to open his mouth enough for the saliva to come out. I had a nurse friend spend a few days with us this week and she was here during his episode this morning and she called it petite mal seizures. He seemed to be better about 30 minutes after he got the Keppra this morning. I sent him on the Trans Aid bus to the Senior Center and haven’t heard anything from them about problems.
It was this kind of thing that caused Dr Pearce to put him on Topamax in the first place. I don’t really want to put him on other medicine, but I don’t want this kind of scary activity going on either.
Response from Valerie Woodard, RN
"1500mg twice daily of Keppra is usually the top-target dose, but we do have folks that require a bit more. We have had a few folks on 4000mg/day up to a couple of folks that I know were on 6000mg/day!!! yikes--that is a lot of medication : )
in any event, I spoke w/Dr.O'Donovan and he recommends increasing the keppra by 1/2 tablet. You can add it to whichever dosage you feel would be most adventageous for him--a.m. or p.m. we should try this for the next few days to see if that will help settle things down now that Topamax is washing out of his system. I will discuss again with Dr.Boggs next week to see if she has further recommendations.
now I get an email from Dr.Boggs recommending resume Topamax at 25mg twice daily for now."
So we went back to the Topamax 25 mg bid.
He hasn’t had much of any problems with the taper until this past week.
030611 had a start in night while on Topamax 75mg bid and then was slightly seizurish the next morning
031311 had a start in the morning while on 50 mg
031811 Started Topamax 25 mg bid
032011 was very seizurish, shaking all over like nervous or cold. When in shower he made a sound like the start of a full blown seizure. Needless to say, I took him out of the shower immediately. We went on to church and he was alright.
032311 had a start while dressing before meds
032411 another start in morning before meds
032511
This morning though, before he had his morning medication, he was very jittery, twitching and having those starts. He collects saliva in him mouth a lot now and 2-3 times the ‘start’ caused him to open his mouth enough for the saliva to come out. I had a nurse friend spend a few days with us this week and she was here during his episode this morning and she called it petite mal seizures. He seemed to be better about 30 minutes after he got the Keppra this morning. I sent him on the Trans Aid bus to the Senior Center and haven’t heard anything from them about problems.
It was this kind of thing that caused Dr Pearce to put him on Topamax in the first place. I don’t really want to put him on other medicine, but I don’t want this kind of scary activity going on either.
Response from Valerie Woodard, RN
"1500mg twice daily of Keppra is usually the top-target dose, but we do have folks that require a bit more. We have had a few folks on 4000mg/day up to a couple of folks that I know were on 6000mg/day!!! yikes--that is a lot of medication : )
in any event, I spoke w/Dr.O'Donovan and he recommends increasing the keppra by 1/2 tablet. You can add it to whichever dosage you feel would be most adventageous for him--a.m. or p.m. we should try this for the next few days to see if that will help settle things down now that Topamax is washing out of his system. I will discuss again with Dr.Boggs next week to see if she has further recommendations.
now I get an email from Dr.Boggs recommending resume Topamax at 25mg twice daily for now."
So we went back to the Topamax 25 mg bid.
posted by Unknown at 1:43:00 PM
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