The ketogenic diet for seizure control - Medications Printout - seizurelife.com
Medications:
Personally, our son has been on the following medications:

Keppra - (caused mood swings, at times very aggressive)
Indications:Partial onset seizures (adjunct)
Metabolism:66% excreted unchanged by the kidneys; some metabolism by the liver
Contraindicated:
  • Hypersensitivity
    Use Cautiously in:
  • OB: Lactaction.
  • Geri: Renal elimination decreased; dose reduction may be necessary.
  • Renal impairment (dose reduction recommended if CCr < 80 ml/minr.)
  • Pedi: Children < 4 yr (safety not established).
  • OB: Use only during pregnancy if potential benefits justifies potential risk to fetus.
    • Adverse Reactions:
  • CNS: dizziness, fatigue/somnolence,weakness,behavioral abnormalities.
  • Neuro: coordination difficulties (adults only)


    • Topamax - (increased Tonic Seizures, and some Status Epilepticus Seizures)

    Indications:
  • Seizures including, partial-onset, primary generalized tonic-clonic, seizures due to Lennox-Gastaut syndrome.
  • Prevention of migraine headace in adults.
    • Metabolism:70% excreted unchanged in urine
    Contraindicated:
  • Hypersensitivity
  • OB: Lactaction.
    Use Cautiously in:
  • Renal impairment (dosage reduction recommended if CCr <70 ml/min/1.73m2
  • Hepatic impairment.
  • Geri: Consider age-related decrease in renal/hepatic impairment, concurrent disease states and drug therapy.
  • Pedi: Children are more prone to oligohydrosis and hyperthermia; safety in children <2 yr not established.
  • Dehydration
  • OB: Pregnancy (use only if maternal benefit outweighs fetal risk).
    • Adverse Reactions:
  • CNS: increased seizures
  • dizziness, drowsiness,fatigue,impaired concentration/memory,nervousness,psychomotor slowing,speech problems,aggressive reaction,agitation,anxiety,cognitive disorders,confusion,depression,malaise,mood problems.
  • EENT: abnomal vision,diplopia,nystagmus,acute myopia/secondary angle closure glaucoma.
  • GI: nausea,abdominal pain,anorexia,constipation,dry mouth
  • GU: kidney stones
  • Derm: oligohydrosis (increased in children)
  • F and E: hyperchloremic metabolic acidosis.
  • Hemat: leukopenia
  • Metab: weight loss, hyperthermia (increased in children)
  • Neuro: ataxia, paresthesia, tremor
  • Misc: suicide attempt, fever

    • Depakote & Lamictal combination - (currently on. better days, but still some Tonic Seizures, not as often)

    Depakote: (currently on)
    Indications:
  • Simple and complex absence seizures
  • Partial seizures with complex symptomatology
    • Metabolism:Mostly metabolized by the liver; minimal amounts excreted unchanged in urine
    Contraindicated:
  • Hypersensitivity
  • Hepatic impairment.
  • Some products contain tartrazinel avoid in patients with known hypersensitivity.
  • known/suspected urea cycle disorders (may result in fatal hyperammonemic encephalopathy)
    Use Cautiously in:
  • Bleeding disorders
  • History of liver disease
  • Organic brain disease
  • Bone marrow depression
  • Renal impairment
  • Pedi: Children, especially under 2yr, are at increased risk for potentially fatal hepatotoxicity.
  • OB: Use during pregnancy is linked to developmental defects, low IQ, birth defects, congenital anomalies, and hepatic dysfunction in the neonate. Use with extreme caution.
  • Lactation: Valproates pass into breast milk. Consider discontinuing nursing when valproates are administered to the nursing mother.
    • Adverse Reactions:
  • CNS: confusion,dizziness,headache,sedation
  • EENT: visual disturbances
  • GI: hepatotoxicity, indegestion, nausea, vomiting, anorexia, constipation, diarrhea, hypersalivation, increased appetite,Pancreatitis
  • Derm: rashes
  • Hemat: leukopenia,prolonged bleeding time,thrombocytopenia.
  • Metab: hyperammonemia
  • Neuro: ataxia, paresthesia

    • Lamictal: (currently on)
    Indications:
  • Adjunct treatment of partial seizures in adults with epilepsy.
  • Lennox-Gastaut syndrome.
  • Conversion to monotherapy in adults with partial seizures receiving a single enzyme-inducing antiepileptic drug.
  • Maintenance treatment of bipolar disorder.
    • Metabolism: Mostly metabolized by the liver to inactive metabolites; 10% excreted unchanged by the kidneys.
    Contraindicated:
  • Hypersensitivity
  • Lactation
    Use Cautiously in:
  • Patients with reduced renal function (lower maintenance doses may be required).
  • Patients with impaired cardiac function.
  • Patients with impaired hepatic function (lower maintenance doses may be required)
  • Pregnancy or children (safety not established as monotherapy).
  • Prior history of rash to lamotrigine.
    • Adverse Reactions:
  • CNS: ataxia,dizziness,headache,behavior changes,depression,drowsiness,insomnia,tremor
  • EENT: blurred vision,double vision,rhinitis
  • GI: nausea,vomiting
  • GU: vaginitis
  • Derm: photosensitivity,rash (higher incidence in children, patients taking VPA, high initial doses, or rapid dosage increases).
  • MS: arthralgia
  • Misc: allergic reactions including Stevens-Johnson syndrome

    • Drugs Used to Treat Seizures
    Drug Use Possible Side Effects
    Carbamazepine
    Partial and generalized seizures Low white blood cell count (granulocytopenia), low red blood cell count (anemia), digestive upset, and visual disturbances
    Clonazepam
      Absence, myoclonic, and atonic seizures and infantile spasms Drowsiness, abnormal behavior, loss of muscle coordination, and tolerance of the drug after 1 to 6 months
    Divalproex
      Absence and complex partial seizures and, when the drug is given by injection, status epilepticus Nausea, vomiting, abdominal pain, diarrhea, weakness, drowsiness, dizziness, tremor, weight gain, and liver damage
    Ethosuximide
      Absence seizures Nausea, lethargy, dizziness, headache, low white blood cell count, and low red blood cell count
    Felbamate
      Complex partial seizures in conjunction with other anticonvulsants when all other drugs are ineffective Headache, fatigue, liver failure, and, rarely, aplastic anemia (a fatal disorder)
    Fosphenytoin
      Status epilepticus Loss of muscle coordination, drowsiness, dizziness, headache, rash, and tingling sensations
    Gabapentin
      Complex partial seizures in conjunction with other anticonvulsants Drowsiness, dizziness, weight gain, and headache
    Lamotrigine
      Complex partial and generalized seizures in conjunction with other anticonvulsants Rash, nausea, vomiting, indigestion, drowsiness, dizziness, runny nose, and abnormal menstrual periods in women
    Levetiracetam
      Complex partial seizures in conjunction with other anticonvulsants Drowsiness, dizziness, and fatigue
    Lorazepam
      Status epilepticus Drowsiness and slowing of heart and breathing rates
    Midazolam
      Status epilepticus Drowsiness and slowing of heart and breathing rates
    Oxcarbazepine
      Complex partial seizures as the only anticonvulsant in adults or in conjunction with other anticonvulsants in children and adults Headache, drowsiness, dizziness, fatigue, nausea, low sodium levels in the blood, and a low white blood cell count
    Phenobarbital
      Partial and generalized seizures and status epilepticus Drowsiness, paradoxical hyperactivity in children, rapid movement of the eyes in one direction followed by a slower drift back to the original position (nystagmus), confusion, and loss of muscle coordination
    Phenytoin
      Partial and generalized seizures and, when the drug is given intravenously, status epilepticus Swollen gums, low red blood cell count, loss of bone density, excessive hairiness (hirsutism), swollen glands, and, in children, impairment of cognitive development
    Primidone
      Partial and generalized seizures Drowsiness, paradoxical hyperactivity in children, nystagmus, and loss of muscle coordination
    Tiagabine
      Complex partial seizures in conjunction with other anticonvulsants Drowsiness, dizziness, confusion, weakness, nausea, abdominal pain, nervousness, muscle tremor, and knee buckling
    Topiramate
      Complex partial seizures in conjunction with other anticonvulsants in adults Confusion, word-finding difficulties, depression, loss of appetite, and kidney stones
    Valproate
      Absence, myoclonic, generalized, and partial seizures and infantile spasms Nausea, vomiting, weight gain, reversible hair loss, and temporary drowsiness
    Vigabatrin
      Complex partial seizures in conjunction with other anticonvulsants Drowsiness, dizziness, headache, and fatigue
    Zonisamide
      Complex partial seizures in conjunction with other anticonvulsants Drowsiness, loss of muscle coordination, kidney stones, loss of appetite, and nausea



    seizurelife.com Website Disclaimer
    The content of the seizurelife.com website is provided for information purposes only. We make no claim as to the accuracy or authenticity of this content. Furthermore seizurelife.com does not accept liability to any person for the information or advice provided on this website or incorporated into it by reference. The seizurelife.com does not accept any liability for loss or damages incurred as a result of reliance placed upon the content of this website.

    This information is provided on the basis that all persons accessing this website undertake responsibility for assessing the relevance and accuracy of its content.

    Please consult your physician