My wife has recently come full-circle back to Gabapentine - but now in combination with Keppra. The dosage involves one Keppra extended release at 10 p.m., and two Gabapentine 300 mg - one at 8 am and another at 4 pm. This combo seems to control her seizures effectively, while providing a noticeable relief from her nerve pain. I’ve read about the negative interaction between K and G but, so far, the results seem to be positive. For the record, we only reduced the Keppra dosage to one tablet, versus the previous two, about three weeks ago, while maintaining the Gabapentine dosage at 600 mg.
Subsequent to the preceding (—which I accidentally failed to post) we went through a trial period with pregabalin (lyrica), taking one 75 MG capsule twice daily, plus two 500 MG ER levetiracetam (keppra) once daily. This was done in hopes of achieving a greater degree of pain relief - which the gabapentin had failed to achieve. It became obvious rather quickly that the Lyrica’s only effect was to create extreme drowsiness, without any other benefit. We have now gone back to two Keppra ER taken once daily around 8 pm, followed by one 300 MG Gabapentin at bedtime - which is usually around midnight for us. Our medication adjustments are all made in consultation with our GP. Currently my wife is still experiencing short duration seizures on occasion - generally resulting from excess stimulation brought on by happiness, excitement, frustration, or the like. She sleeps well at night but she is relying more and more on her wheelchair, in lieu of her walker, for daytime mobility. We’re both 83 years old.
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Our goal is to use the lowest dosage of medication that provides the greatest good. That said, we both agree that we can tolerate a certain number of seizures, with the more significant goal being pain reduction. Accordingly, we may move to one Keppra per day and three Gabapentin in the next two or three weeks. I’m not overly enthusiast about Gabapentin but it does lay claim to limited pain reduction while Keppra, in general, does not.
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@Cracker I am on Levetiracetam twice daily, my neurologist has said that in the next 3-5 years he would like to reduce if I keep being seizure free