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Suggest Treatment For Epilepsy In A Mentally Challenged Kid

Posted on Tue, 3 Feb 2015

Question: Dear Sir, my brother is a mentally challenged boy with epilepsy disorder. he is under medicines such as valparin1000 mg, levipil1500 mg, lamez 400 mg and revotril 4mg daily. lately he has developed peculiar habits of hitting us in anger with any thing available, throwing furnitures and other items at home and frequently remain in hypertention without any cause. local psychaitrist has prescribed olimelt 5mg.but this medicine has increased his epilepsy and he is unconcious all the time after taking medicine. kinly suggest what to do..

Answered by Dr. Seikhoo Bishnoi (12 minutes later)

Brief Answer:
Olanzapine is known to reduce seizure threshold and should be stopped

Detailed Answer:
Hello thanks for choosing HCM for your health related queries

Your brother is mentally challenged and have epilepsy. He is taking Valproate 1000, Levetiracetam 1500, Lamotrigine 400 and Clonazepam 4 mg daily. For his anger outbursts and violent behaviour he has been advised to take Olanzapine 5 mg per day.

Olanzapine is a Second Generation Antipsychotic (SGA) drug and the drug is known to lower seizure threshold and it can result in aggravation of seizures in patients of epilepsy. As he has developed seizures with drug I would advise you to stop the drug and report to his psychiatrist.

For patients of epilepsy usually First Generation Antipsychotic (FGA) drugs prove safe. Medicines like Haloperidol, Sulpiride are considered as relatively safer drugs that can help to reduce aggression in patients of epilepsy with mental retardation. You can discuss with his psychiatrist for prescription of the drugs.

Thanks, don't hesitate to ask again if you have more doubts.

Take Care

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Seikhoo Bishnoi (2 days later)

After having consulted with the local psychiatrist for the continuation of the medicines of my brother, i.e., Valproate 1000, Levetiracetam 1500, Lamotrigine 400 and Clonazepam 4 mg daily. For his anger outbursts and violent behaviour he has been advised to take Olanzapine 5 mg per day by the doctor at night only and but his convulsions has stopped and he is under controlled behaviour..pls suggest what to do?

Answered by Dr. Seikhoo Bishnoi (6 minutes later)

Brief Answer:
Continue the drugs as per prescription only

Detailed Answer:
Hello thanks for asking again

If his seizures are under control and didn't increase in frequency even after giving Olanzapine then there is no harm in continuing the prescribed medicines. All other medicines he is taking will act as anti convulsants and mood stabilisers both. Olanzapine have potential to reduce seizure threshold but as the drug resulted in improvement of his behaviour then it can be given but under proper prescription only. The drug can increase seizures but it depends upon opinion of his psychiatrist only whether to give drug or not. You can consult for some other drug like I have mentioned in last answer, if seizures reoccurs.

Thanks

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Seikhoo Bishnoi (23 hours later)

Sir, can you pls suggest as to what dose of haloperidol or sulpiride should be given to my brother including other medicined he is taking.

Answered by Dr. Seikhoo Bishnoi (3 minutes later)

Brief Answer:
Haloperidol is started with 0.5 mg doses and can be increased accordingly

Detailed Answer:
Hello thanks for asking a follow up

Haloperidol is commonly used and is available. The drug is usually started with 0.5-1 mg per day doses and depending upon patients clinical condition and response doses are adjusted. The drug is relatively safer in epilepsy as compared to other second generation antipsychotic drugs. The drug is a prescription drug and you have to get a prescription before starting the drug.

Thanks

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj