Need help :(

My friend has an autistic 16 years old boy who has epilepsy ,Generalized Tonic-Clonic , he was using Depakene chrono for a long time + lemictal, he was ok with it till september 2007, the blood tests showed that the Depakene chrono was increasing in his blood, so the doctor suggested to stop it and replace it by Keppra, then , he was having seizures one after the other .. so they added the depakene to his daily taken medications ,, he was ok for almost 4 weeks .. now again the blood tests show that the depakene is reaching 850 .. the question is .. why is the depakene increasing in the blood ?? is there any other good medication with less side effects??

[JainMD]

Hi,
How is your friend’s son feeling?
What all medication is he on?
I think you should not stop depakote suddenly as this would increase the chances of seizures. You should as the pediatric neurologist to gradually decrease the dose of Depakote to minimum possible level where it should not produce side effects but also have anti-seizure activity.
I think it is some drug interaction between Depakote and any other drug which he is taking causing the concentration of Valproic acid to go up rapidly.
I think you should be asking the doctor to re-evaluate his drugs pattern and other co-administered drugs interaction.
Keep me informed if you have any queries.
Bye.

[Mayar]

Hi ,

Thank you so much for answering me back .. today we went to his neurologist, as u suggested he decreased the Depakene from 750mg to 500 , 250mg twice a day .. asking the mother to observe the boy .. and another blood test will be taken next week .. he said if it doesn't work . he'll shift to tegratol ( i guess that's was the name ) .. any other better recommendation?
Thanx a lot

[JainMD]

Hi,
Tegretol is a good medication. The active compound is Carbamazepine. You need to look out for development of rash in your friend’s child, if observed you can report the incidence to the neurologist and he probably have to change anti-convulsants again.
Did they ask about other co-administered drug? Does any other drug is causing any increased concentration of Depakote in body?
Keep me informed if you have any queries.
Bye.