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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5423
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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My 17 year daughter had been getting seizures within 20

Customer Question

My 17 year daughter had been getting seizures within 20 minutes of sleeping. She was on 900 mg of Triliptal ( not the XR ) and 250 mg of Keppra XR. She was getting seizures every 80 to 90 days. Then her neuro asked her to take an additional 300 mg every night. So he is now taking 1200 mg ofTriliptal + 250 mg of Keppra XR every night around 9:00 PM. She got a seizure after 125 days. Now her neuro has upped her triliptal dosage to 1500 mg ( all to be taken at one time in the night ) and aske dto stop the 250 mg of Keppra XR completely.
Looking for a second opinion on this. Is it Ok to take 1500 mg Triliptal at one time?
Submitted: 2 years ago.
Category: Neurology
Expert:  Dr. Bob replied 2 years ago.

Daily doses from 600 to 2,400 mg/day have been shown to be safe and effective for adults with normal renal function, although most patients are not able to tolerate the 2,400 mg/day dose without reduction of other antiepileptics, mainly because of additive CNS-related adverse events, such as sedation.

These doses are typically given in a twice-a-day regimen. If the total is 1500mg per day, it would normally be divided.

Daily doses above 2,400 mg/day have not been studied systematically in clinical trials.

For children 4-16 (or very small adults), the proper dose depends on weight. Doses up to a maximum dose of 46 mg/kg/day, to achieve the desired clinical response, are used.