Case for lamotrigine?
Case for lamotrigine?
I have a family member age about 62 who began psychosis about 3 years ago. A neurologist discovered seizure activity with an EEG test. Patient didn't follow up because Patient's mother had same condition in retirement years and psych meds made her worse until she was mentally gone. Patient saw same neurologist from 3 years ago - a few months ago, again EEG showed seizure. During the elapsed time psychosis increased and family figured out it was clinical and started at psychologist who prescribed lexapro. That caused hallucinations and aggravated psychosis. Another psych dr. prescribed risperdol, then two weeks later abilify. Both had disastrous results. catatonic demeanor or hallucinations and tardive. It took three months for the Patient to recover from two weeks of risperdol and 6 weeks of abilify symptoms mentioned. After 2nd EEG Patient tried Keppra and went angry/belligerent in 3 days and had to stop. At this point, none of the neuorleptic meds have helped, all made conditions worse. Any dopamine boosting substances or supplements increased psychosis as well as moderate to excessive sugar in diet (as we witnessed during monitoring Patient daily.) Daily treadmill exercise helped recovery and builds brain cells too.
While searching the issue of seizures I came across a study that reveals a genetic explanation about seizures by glutamate toxicity that leads to dopamine toxicity and LTP or long term memory loss in the hippocampus all as a result of glutamate toxicity and a microdeletion in a gene. Some of you may have seen our blog
http://orthosz.blogspot.com which tracks this Patient's progress. We have been unable to get a Dr. to even try Lamotrigine because they all approach this matter from a treat the symptoms by observation perspective rather than find the underlying cause of the psychosis. We (the family members active in the Patient's progress) want to try Lamotrigine because it appears from our reading it would address all the known and suspect issues involved: seizures, drop attracts, glutamate toxicity in hippocampus and quite possibly the psychosis caused by the increased dopamine of the chain of events. There's more details of the study on our blog.
There's a Dr. Restak who's got an article on "Complex Partial Seizures Present Diagnostic Challenge" here's a link for this
http://www.psychiatrictimes.com/p950927.html
Basically, there's a high probability that patients with these psychosis symptoms never get a fair shake at recovery because they are prescribed neuroleptics only to mask the symptoms and return people back to their catatonic socially safe lives (my own opinion and over simplification.) But as I read this article, words jumped out at me as descriptions of the seizure experience were what our Patient has experienced, including the fear. It makes me think we're onto something somewhat of a possible solution.
We're going to try to convince our family Patient to seek a specialist and ask for a trial of Lamotrigine. I wanted to bring this issue to the board here so it may help someone if they have this condition and are not getting treated by doctors correctly. Our Patient was just released by a involuntary psych hospital with a two week prescription for Quetiapine only! After all the seizure evidence (which included childhood seziures)! Quetiapine (Seroquel) a drug that has 50% chance of diabetes and lowers seizure threshold for many people making the seizures happen more often! When I asked them what test they use to determine if a Patient is ready for release the answer was "observation." They look at the patient.
Doesn't seem like scientific method for detecting complex partial seizures. 8(