Just started DH on Keppra last night, then this morning. He's been very lethargic, napped a lot today and he never naps. But he had no jerks today - he has absence seizures.
Yes, H has been on Keppra, and is now on the generic, levitiracetam (sp, should be close).
His first seizure was in 2000. Initially he was treated with generic Dilantin. His seizures were tonic-clonic. Starting in 2004 a specialist neuro suggested augmenting that with Keppra, and over the next couple of years he was transitioned to Keppra alone. I'm guessing that happened around 2008. I remember that when he first started Keppra he was disoriented and kind of dazed. He seemed to adjust to it fairly quickly. Now he continues with it at 1000mg bid.
Absence seizures can appear as a result of abnormal electrical discharge in the brain. They are also called petit mal siezures. They generally last from a few seconds to a very few minutes and the person does not remember anything about it happening. Some conditions that may provoke them are ALZ, Parkinsons, Epilepsy and brain injuries. With DH it starts with jerking arms, and if he is standing, he will fall unless I am right there to steady him. A totally blank look, doesn't respond to me while it is happening. Afterwards, he is back to 'normal'.
He sleeps so well at night, I'm hesitant to give him anything to make him nap during the day - he never has until today.
hey Vickie , bobby takes keppra for the myclonic jerks. he can only thak about a third to a half of teaspoon in the mornings before he gets up. he is best if he naps it off a bit , it tends to make him snappy if he doesn't and any more than that and he is seeing things and talking out of his head but the small dose does enough to cut the jerks in half at least. most of the time he will nap for about an hour after the dose and then he is good. we don't do it at night cause it works just the opposite at night for him and he stays awake talking to things and seeing things. he has a hard time with most all meds that have a sleep side effect to them :( good luck
My husband was on kepra for a few months. He became zombie like. He took an AM & PM dose. The nursing home. at my request, cut out the am. He wasn't as groggy. His petit mal seemed evident only when he was extremely relaxed or sleeping.
DH doesn't take liquid- he has the 500 tablet, twice a day. He did sleep well last night - about 13 hours! We'll see how it goes durig the day today. As we all know, everyone is different and reacts differently. Thanks for your input. I just don't want him zombie-like - we're in the process of enrolling him in daycare for a few hours per day- hopefully, but if he's sleeping a lot during the day, that isn't going to work.
Vickie, Lloyd took Keppra and it turned him into a zombie drooling all over himself. He is on liquid Neurontin now (1/2 tsp at bedtime) and it has helped with insomnia, seizures, and myoclonus. I no longer have him on any sleeping pills. I sometimes wonder why the doctors start our lo's off on 500 mg of anything. Our PCP starts with just a tiny dose and increases as needed from there. Lower dosage=less impairment for Lloyd.
i agree with linda mc. not sure why drs always recommend high doses to begin new meds and increase as necessary. with dementia patients things tend to affect them more profoundly esp medications. i am not a dr but 500mg/twice a day to start does seem alot it may be why hes sleeping alot vickie. if his sleep is excessive ask the dr if you can cut the dose some. i only give very tiny doses of neurontin as well for the jerks and its worked for years with very little side effects mercifully. linda mc i am elated to hear your lloyd is doing so well on the neurontin!! yay! isnt it wonderful when we finally get the right stuff.
Started him on Keppra on a Thurs. night; all weekend he slept mostly in the day-time, or sat staring; also slept good at night, though. Monday called Dr.-said to half the dose, give only at night. Thought about it and only gave him 1/2 the dose Mon. night. Not any better Tues. or yesterday. I didn't give him any last night - this morning he is already more alert! DH is very sensitive to most meds, so I have to be careful. I do not want him not doing things. I'm afraid to leave him alone now - so need help.
Good news is, told our PCP's nurse yesterday that I needed some help. Home health nurse is coming out this morning to do an assessment!
Divvi, his neuro would not give it to me when I asked at his last visit. BUT he insisted Lloyd had to be on something for seizures. He prescribed Dilantin that Lloyd ended up being allergic to so I went to the PCP and asked him. No problem and the Neurontin has stopped the seizures, calmed the myoclonus, and helps him sleep more soundly at night. All in one little half teaspoon!!! He doesn't take sleeping pills at all anymore. They seemed to cause problems in the mornings when he would try to get up. His eyes would be open, but he couldn't function for at least an hour (sometimes longer).
Vickie, sometimes I think the doctors think zombies are easier to care for. And in some cases there may be people who would rather wipe off drool than chase their loved one around all day long. I'm a chaser. Don't get me wrong. There are times I would like to crazy glue his butt to a chair, but I will take clarity any day.
Vickie: At one point in my career I was an R&D Pharmacist. You may want to try alternate day dosing of the half strength dose. Your objective should be to try to find the least possible dose of Keppra that will minimize his seizures while not overly sedating him Geriatric patients aging influences every aspect of physiologic drug processing. Medications while they may have a decreased serum concentration, have a prolonged half-life. While the absorption of oral medications from the GI tract remains relatively constant medications, bioavailability and clearance dramatically change with aging. These changes become the most pronounced after age 75, when kidney and liver function become limited.
Thanks so much, Marty. Have a call in the to the Dr. to tell him my decision to not take the Keppra. I'll see what he says - but there have been so many meds he has given in the past and most always has all of the side effects. I'll take quality of life every time. Today, he has set the table, unloaded the dishwasher....has not napped at all by 2:00 pm.