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Suggest treatment for side effects of Epilan

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Posted on Fri, 8 Jul 2016
Question: My Wife 46 Yrs IS taking antiepileptic drugs. She was taking Mazetol - 200mg and Epilan (Phenobarbitone -30 mg & Phenytoin sodium-100 Mg) three times per a day. She has no epilepsy since October-2001. We have not consulted any Dr. since last eight years.HER EEG REPORT OF 2008 WAS VERY NORMAL Now In CURRENT she takes 100 Mg. Mazetol -THREE TIMES PER DAY since 5 years and epilan ( as per above composition) 0.5 tablets three times per day by our selves. At present she has no side effect except gum problem & LIGHT VERTIGO during menstrual period. . We tapering off epillan every six months. But just we went to go one neurophysician, he disappointed us and told us that she is taking these drugs since 28 ys..so IF SHE WILL TAPERING OFF MORE OR CLOSE TO TAKE THESE TABLETS THEN THERE iS VERY HIGH RISK OF RECURRENCE. He has advised to do MRI instead of EEG and donot to take risk of tapering off medicine. My question is that she has no epilepsy since 2001 then Why she cannot close medicine?? SHE HAS TO TAKE THESE DRUGS PERMANENTLY UP TO LIFE ?? By these drugs-osteoporosis will not occur ?? PLEASE GUIDE US PROPERLY AND GIVE YR BEST OPINION...IF ANY MORE CLINICAL TEST ARE REQUIRED PLEASE SUGGEST US.
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Answered by Dr. Bruno Mascarenhas (55 minutes later)
Brief Answer:
Both MRI and EEG are needed to decide about stopping drugs

Detailed Answer:
Hi,

Welcome to HealthCareMagic.com I am Dr.J XXXXXXX Anto Bruno Mascarenhas, and I am here to help you. I have read your question with care and understand your concerns.  

Let me try to address them

1. Anti epileptic drugs do have side effects, but side effects of fits are many times more dangerous than side effects of these drugs. So we have to choose the lesser evil

2. You have to do both EEG and MRI Brain. If any one is abnormal, she has to continue drugs. there is no other way

If both are normal, we can taper the drugs. after tapering the drugs for 3 weeks, you have to repeat the EEG. If it is still normal, we can taper further. If EEG becomes abnormal after tapering, she has to take drugs life long

If the EEG is normal at 3 weeks, we will continue to taper and take another EEG at 6 weeks. If it becomes abnormal, we will start drugs at the dose we had in third week. If it is normal, we will reduce the dose further

We repeat the same process at 9th and 12th week

If EEG becomes abnormal at any stage, we continue the drugs at the dose of previous stage

If EEG is normal, we can stop the drugs altogether

This is the protocol we follow and many people have stopped drugs and are living without fits for more than five years

Hope you found the answer helpful.

If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions.

Best Wishes for Speedy Recovery
Let me know if I can assist you further.
Take care.

-oOo-

PS 1 : After all your doubts have been cleared, kindly (a) Close this Question (b) Rate my Replies and (c) Give your Feedback.

PS 2 : In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at http://bit.ly/askdrbruno
Above answer was peer-reviewed by : Dr. Sonia Raina
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Follow up: Dr. Bruno Mascarenhas (59 minutes later)
Suppose by Grace of God, If EEG & MRI both will reveal normal ( as we have faith in God) then ( 1) Which medicine should tapper first--epilan or mazetol ?? And as per yr kind opinion , in how much extent should taper ?? at present she is taking Mazetol-100 mg three times and Epilan 1/2 three times. ( 2 ) Do you suggest any further laboratory report for health check-up as she is taking these drugs since 28 yrs. ?? ( 3 ) As We are coming from very lower middle class then if we will perform EEG & MRI at Govt. Civil Hospital then their result will ok ??
doctor
Answered by Dr. Bruno Mascarenhas (20 minutes later)
Brief Answer:
No need of other tests. Govt Hospital tests are Enough

Detailed Answer:
Dear Sir,

Welcome Back

1. You have to taper Carbamazapine first followed by Phenytoin

2. No need of other tests

3. You can do the tests from Govt Hospitals

Take care
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Dr. Bruno Mascarenhas

Neurologist, Surgical

Practicing since :2000

Answered : 806 Questions

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Suggest treatment for side effects of Epilan

Brief Answer: Both MRI and EEG are needed to decide about stopping drugs Detailed Answer: Hi, Welcome to HealthCareMagic.com I am Dr.J XXXXXXX Anto Bruno Mascarenhas, and I am here to help you. I have read your question with care and understand your concerns.   Let me try to address them 1. Anti epileptic drugs do have side effects, but side effects of fits are many times more dangerous than side effects of these drugs. So we have to choose the lesser evil 2. You have to do both EEG and MRI Brain. If any one is abnormal, she has to continue drugs. there is no other way If both are normal, we can taper the drugs. after tapering the drugs for 3 weeks, you have to repeat the EEG. If it is still normal, we can taper further. If EEG becomes abnormal after tapering, she has to take drugs life long If the EEG is normal at 3 weeks, we will continue to taper and take another EEG at 6 weeks. If it becomes abnormal, we will start drugs at the dose we had in third week. If it is normal, we will reduce the dose further We repeat the same process at 9th and 12th week If EEG becomes abnormal at any stage, we continue the drugs at the dose of previous stage If EEG is normal, we can stop the drugs altogether This is the protocol we follow and many people have stopped drugs and are living without fits for more than five years Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow up questions, then please do not hesitate in asking again. I will be happy to answer your questions. Best Wishes for Speedy Recovery Let me know if I can assist you further. Take care. -oOo- PS 1 : After all your doubts have been cleared, kindly (a) Close this Question (b) Rate my Replies and (c) Give your Feedback. PS 2 : In the future, for continuity of care, I encourage you to contact me directly in HealthCareMagic at http://bit.ly/askdrbruno