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Continue Lamotrigine, stop, or try Keppra?

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To keep it short: HPPD for 15 months. Drug free, eating and working out. Overall a lot of stress since I'm in medical school.

I have now tried Lamotrigine for about 1.5 month.
You're suppose to go 2 weeks on 25mg, 2 weeks on 50mg and then continue on on 100mg (which is lowest effective dose).

When I got to 50mg I feelt like my dp/dr symptoms were reduced and I looked forward to starting 100mg since I thought it would be "even better".
Sadly, 100mg got me feeling weird and after 1 week I went back to 50mg after consulting with my neurologist.
Now, 50mg feel better, but I still feel a lot of anxiety. I dont know if it's because finals are coming up but I feel almost as bad as I did ONE YEAR ago.

Now I'm not really sure that to do. Continue on 50mg, try to increase to 100mg again? Or stop medication totally?

My neurologist also said we can try Keppra or even a newer version called "Brivaracetam".


Any advice?

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Depends, do you feel like your symptoms are getting better and better on 50mg ? Or just getting better and then stabilizing ? 

Also, Keppra has had a fair bit of success with several HPPD'ers. Maybe give it a shot if you feel like lamotrigine has done its job so far ?

As far as I read, Brivaracetam seems like a more potent and overall better version than Levetiracetam, it's also something you could try if Keppra isn't satisfying.

I'd still leave 1 or 2 weeks between each medication just to give your brain a rest and a chance to flush all those chemicals away.

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Yeah it got better on 50mg then I continued with 100mg (as told my doctor) and I thought the symptoms would decrease even more. However I got worse dp/dr and then I went back to 50mg. And since I went back I haven't feelt as good on 50mg as I did in the beginning. I might try Keppra but I think I have to give myself a break with at least 2-4 weeks of any meds before. And I don't think I will try anything new until vacation.

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Nice to see another med student! Where do you study and what year?

I noticed you had made another post on whether starting with meds or not was a good idea. As I understood it, you wanted to try things out after the 12 month mark, however, as you were seeing some improvement, Jay adviced you to see where that goes before trying anything. How come you started?

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  • 2 weeks later...

Check out my thread here if you find that Keppra is doing nothing for you :) I'm on a combination of Topomax and Buspar, these drugs take a while to work and stabilize in your system, i've been on them for about 2 weeks now, as well as lamotrigine, and I feel absolutely incredible. Mental clarity, reduced stress, tension headaches and mental fog and fuzziness are completely gone etc etc. Check out the thread and read up on it and see if it's relevant to you. :) 


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Always wondered if briveracetam would have effected me different than keppra. Unfortunately I’m not willing to find out as I have strong immune reactions to taking keppra. 


The suspected antidepressent effects from lamotrigne are, and I’m not looking this up so correct me if I’m wrong, increases bdnf after chronic usage and increased AMPA receptor function in response to lowered NMDA (compensatory in mature but similar end result as drugs such as sarcosine, long term effects of ketamine, and coluracetam to some extent). Now increased ampa functioning can boost nicotinic receptor functioning too—something that many with hppd find uncomfortable (at least I’ve read anactodaly and experienced this myself when trying to continue smoking cigarettes in my early hppd stage. 


Keppra, along with inhibiting sv2a/nmda, inhibits ampa. So if you’ve perhaps boosted your ampa too much with lamictal, perhaps you’ll find that keppra helps calm that down. I’m not a fan of lamictal—if it works then great. But I don’t theorize that it works for correcting what I feel are many major players in the hppd etiology FOR SOME (reduced nmda functioning via excitotixic event (5ht2a excitation—>glutamate overload), increased ampa via compensation, increased alpha 7 nicotinic via ampa). That doesn’t mean though that parts of your brain don’t have high glutamate still though. So if you find lamictal working then stick with it. Lowest possible dose is best. If you try keppra, my experience is you’ll know if it is working pretty quick. It was within two days for me the first time and the second time after about a month. 


one really has to look at their symptom set though In deciding which meds are best for them. Look for what things you are sensitive to and find out common MOA that set you off. It’s so hard especially if ones hppd hasn’t settled yet and things are still evolving.  


If if you’re looking for new things to try, take a look at my bpc-157 thread. I’ve had more success with this peptide than.. really anything else I’ve tried. Another member read it and decided to give it a shot and apparently, according to his message to me earlier today, can’t believe how much it has helped him in such a short period of time. 


Hope le you find out why the lamictal is turning on ya!



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