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Suggest Alternative Medication For Keppra And Neurontin

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Posted on Wed, 31 May 2017
Question: My husband has suffered petit male seizures for over 35 years. He had a mild stroke during his first ( of 3) aortic valve replacements at the age of 30, he is now 68. He has a left temporal lobe foci of activity. He has been on many meds, starting with dilatin, progressing thru phenobarbital, tegretol,etc. He is now on keppra and neuron tin, both of which are very sedating. Is there anything new without the sedating side effects?
doctor
Answered by Dr. Dariush Saghafi (43 minutes later)
Brief Answer:
You may wish to try......

Detailed Answer:
The problem is that EVERY antiepileptic medication is potentially sedating by the very nature of how it works to prevent or stop seizures....it SEDATES or CALMS DOWN....or REDUCES NEURONAL ACTIVITY in a GENERALIZED fashion throughout the brain. We do not have medications that are free from this type of sedating effect and it really depends upon the individual patient, other medications they may be taking, other comorbid they may have, strength of their constitution, how active they are, how much exercise or extracurricular activity they get, how well they sleep, etc. as to just how sedating a medication can be. And there is an age factor since basal metabolic rates in the young patient (20's, 30's) are much higher than beyond.

Having said that other medications that you may try (since I don't know the exact detail of the list he's tried) would be things such as:

Vimpat, Lamictal, Onfi, Trokendi, Lyrica, Carbatrol, and Trileptal

Some of these medications are older, some are newer, most should probably be used as adjuncts to other primary meds but his doctor may try them in isolation if oversedation is a concern.

The doctor may also do a full metabolic workup on him with bloodwork and even other diagnostic studies such as a sleep study to guarantee first and foremost that there are not any additional features of illnesses that could cause or contribute to sedation such as thyroid dysfunction, myasthenia gravis, Chronic Fatigue Syndrome, Fibromyalgia, Anemia, Reduced productivity of the Bone Marrow as in myelodysplastic disease of some sort.

If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dariush Saghafi (37 minutes later)
Thank youfor your attention to this issue. I try my very best to give my husband the best of care. He will be seeing a new neurologist soon as we have just relocated from Michigan tooo Tennessee. His last neurologist treated every complaint with opioid, there has to be a better way.
doctor
Answered by Dr. Dariush Saghafi (7 hours later)
Brief Answer:
I agree with you---

Detailed Answer:
I hope your husband has not become addicted to opiate substances because how he was treated. And there are definitely better ways to be treated. Sorry that his former neurologist was not able to do better for him.

Since Ohio is between Michigan and Tennessee you are welcome to visit us here in Cavaliers and Ohio State Buckeyes Country if you would ever like to experience a neurology consultation with XXXXXXX Hospitality. LOL.....

I would be very interested in knowing how things turn out for your husband after you settle in with the new neurologist. Please get in touch with me at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

My thanks as well for a high 5 star rating if you've found this consultation of value.

This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

All the best to you.

P.S. We are all coming down to XXXXXXX at the end of May because my daughter is competing in a Regional Cross Fit competition. Hope we can find a nice place to stay....We did Opryland last time we were in that area...but it was so darn busy....Memorial Day Weekend, it will probably be the same!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2473 Questions

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Suggest Alternative Medication For Keppra And Neurontin

Brief Answer: You may wish to try...... Detailed Answer: The problem is that EVERY antiepileptic medication is potentially sedating by the very nature of how it works to prevent or stop seizures....it SEDATES or CALMS DOWN....or REDUCES NEURONAL ACTIVITY in a GENERALIZED fashion throughout the brain. We do not have medications that are free from this type of sedating effect and it really depends upon the individual patient, other medications they may be taking, other comorbid they may have, strength of their constitution, how active they are, how much exercise or extracurricular activity they get, how well they sleep, etc. as to just how sedating a medication can be. And there is an age factor since basal metabolic rates in the young patient (20's, 30's) are much higher than beyond. Having said that other medications that you may try (since I don't know the exact detail of the list he's tried) would be things such as: Vimpat, Lamictal, Onfi, Trokendi, Lyrica, Carbatrol, and Trileptal Some of these medications are older, some are newer, most should probably be used as adjuncts to other primary meds but his doctor may try them in isolation if oversedation is a concern. The doctor may also do a full metabolic workup on him with bloodwork and even other diagnostic studies such as a sleep study to guarantee first and foremost that there are not any additional features of illnesses that could cause or contribute to sedation such as thyroid dysfunction, myasthenia gravis, Chronic Fatigue Syndrome, Fibromyalgia, Anemia, Reduced productivity of the Bone Marrow as in myelodysplastic disease of some sort. If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out. Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.