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Why does levetiracetam/Keppra seem to be regarded as superior to lamotrigine/Lamictal in HPPD treatment?


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So given that agomelatine doesn't seem to have done much of anything it's very likely I'll be prescribed Lamictal next Tuesday. When I mentioned levetiracetam the psychiatrist I'm seeing either didn't have much to say about it or didn't want to go there for some reason, but he praised Lamictal and said it'd be the next move in my treatment.

 

Thing is, I know Keppra tends to be the most well-regarded anticonvulsant by members here and seems to have the most success stories, but I'm not sure if that's just because more people have tried it. I'm not well-versed in the pharmacological actions of either and how they differ but a lot of studies/reports seem to regard them as relatively comparable as far as treatment of epilepsy goes. I know there's the study, but is there any reason Keppra was chosen for the study over Lamictal, and were the same study to be done with Lamictal is there much reason to believe the results would be less positive?

 

I really just want to know if there's any concrete reason that I might want to really push for Keppra over Lamictal; I don't especially want to get into an argument about this stuff with a professor of psychiatry unless I'm confident there's a solid basis for doing so :P

 

Oh, and while I'm at it I'd like to ask: if one's HPPD fails to respond to treatment with one anticonvulsant, is that reason to believe it won't respond to another and that avenue of treatment should be abandoned?

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The Keppra study is still up for debate. Kinda funny that no one has called the institution that conducted the research and asked about what they meant about "flashback frequency".

The thing is that Keppra is not as mood stabilizing as Lamictal. I know that Keppra often is prescribed in seizure treatment and dementia while Lamictal is used in both but also in bipolar disease. My psych never heard of Keppra, but the med docs had

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The Keppra study is indeed a bit dodgy - but it is also useful if you want to get it prescribed.

 

Lamotrigine is an interesting med and I'd like to possibly give it a go - although the side effects are a little off-putting. Although apparently they are more common in women.  ;)

 

A few on the visual snow Facebook group have tried it with some success. Unfortunately it's similar to Keppra in that it can take a long time to work, with some people saying it takes many months. So you'd probably need 6 - 12 months to know for sure if it helps. I suspect most people who try it only do so for a very short period of time, and so we probably do not truly know how good it is at treating visual snow syndrome and/or HPPD.

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Are you aware it's often prescribed in cases of "pure" DP/DR with what seems to be a pretty decent success rate? It's discussed far more often on the dpselfhelp forum as well as in scientific literature: see here http://apt.rcpsych.org/content/11/2/92.full

 

I'm really not aware how the neurobiology of HPPD-related DP/DR compares to that of other cases but I can't help but have a lot of hope. Ought to check out if many people on here have tried/had success with naltrexone or naloxone as those are praised quite a bit as well.

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Are you aware it's often prescribed in cases of "pure" DP/DR with what seems to be a pretty decent success rate? It's discussed far more often on the dpselfhelp forum as well as in scientific literature: see here http://apt.rcpsych.org/content/11/2/92.full

I'm really not aware how the neurobiology of HPPD-related DP/DR compares to that of other cases but I can't help but have a lot of hope. Ought to check out if many people on here have tried/had success with naltrexone or naloxone as those are praised quite a bit as well.

Well, i believe there is a difference in "pure" DP/DR and the HPPD one. Keppra did a lot to clear up visuals and by that diminishing DP/DR. Meaning that its better to treat the cause of the symptom rather then the symptom.

Anyway, i started lamotrigin at a low dose and switched to Keppra. I also tried valproate at a Liw dose. All these three had a similar effect on my HPPD. I do not think there is a major difference, but Keppra only blocks the calcium channels while the others are messing with other things.

Thats why Keppra is used as "strictly neurological" and not psychological, like bipolar. By that, its not a bad thing to go on lamotrigine but i do wanna keep my affections intact and Keppra is doing its job, killing the cause of the issue.

If shit hits the fan in the world economy i might think twice and try a switch. Keppra is ridicoulus expensive and without the social system paying the cost, i wouldnt afford it.

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I have been on lamotrigine for 6 months, high dosages had no affect on me.

I would like to try Keppra but it is too expensive. 

Maybe some of you have a source where can I buy it cheaper.

Eventually since I have anomalies in EEG I could convince a psychiatrist to prescribe me Keppra. I mean that I could trick a doc that I am an epileptic and get keppra refunded.

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I was hoping to add something useful to this conversation, as I did have some valid arguments at the time I had to choose between the two. Can't remember them though. Think it had to do with safety and side-effects, with Keppra being the superior IMO. Bummer I can't remember. In any case, I saw you got it prescribed, so let's hope it works for you!

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  • 2 years later...
  • 2 weeks later...

For what it's worth, after increasing my lamictal dosage from 150, which I had been take for months, to 200mg I saw a drastic change in my symptoms. Ghosting now surprises me when it happens because it has pretty well disappeared. No more distortion on walls. Visual snow at night has reduced to the point that it no longer "blinds" me but it is still some what there. Most importantly the brain fog, depression and anxiety have diminished greatly. From 25-150mg I hadn't noticed much more then slight reductions in my visuals. Everyone is different, obviously, but I don't what people to completely dismiss these drugs.

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