Switching from Keppra to Lamotrigine (Lamictal) - have questions

My boyfriend was recently (3 days ago) asked to switch from Keppra to Lamotrigine by his doctor. He is currently on 500mg of Keppra (it’s supposed to be 1000mg but he only takes half because a 1000mg makes him feel loopy and depressed, unable to function at work). The doctor knows that.
After his last seizure, the doctor decided to add Lamotrigine 25mg with an 8 week switchover process. By the end of those 8 weeks, he will be on 100mg Lamotrigine. Currently we’re not sure if he’s going to stop Keppra completely at the end of those 8 weeks but we’re assuming he’ll be tapered off gradually and then only be on Lamotrigine.

Here’s our question: what was your experience like switching between meds or even just taking Lamotrigine? My boyfriend has been taking the new meds for 3 days and he’s says his brain “feels like it’s swirling all the time”. He doesn’t feel coherent enough to form a thought, hold up complex conversations and feels like he’s falling deeper into his depression.

My advice to him was to still go through the 8 weeks, thinking that maybe his body needs time to adjust to the new med. But seeing him like this is hard. Is this normal? Does it always feel like this on the meds? Will it actually get better or does it just stay like this? Should we bring up how he’s feeling to his doctor?

Thank you so much in advance!


I’ve not gone through this but I’ve heard plenty of people say that Keppra can be horrible. Lamotrigine may also have some unpleasant side effects. What I can say is that, from reading on here, I get the impression that getting onto Keppra in the first place is the most difficult. Some people get past that initial difficulty and others end up trying a different drug. So, yes, I think it is common to be in the situation he is in. To a great extent patience may be required. On the other hand some people just don’t get on with certain drugs, so you do have to try each for a sensible period to determine which is the least worst option for you (or, in this case, for him).

I hope others with more direct experience will share how they got on but, basically, yes very usual to be in this situation and don’t panic.

Lots of love to both,


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Hi Richard!

Thank you so much for your response! Yeah, from the reading I did, it does seem like the 8 week transition period from Keppra to Lamotrigine is…hard. I’m trying to look for a support group in Toronto that we could attend, just to have some support during this transition. We’re also looking into treatment options, hospitals and doctors because I’m not happy with the level of care my boyfriend is receiving currently.

We’re going to wait out this 8 week period before we make any decisions on whether Lamotrigine is good for him or not.

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It seems to me that sometimes there is no perfect solution (and moving too quickly won’t show you which is best) so I think patience and resilience are your travelling companions. It’s not at all an easy exercise.

Feel free to use this place as a means of support: it is what we are here for, and I know there are others here who’ve gone through the same. It just takes days for different people to see posts that they can respond to and tell you something straight from their experience.

Hang in there!

Dear Kamika,

Keppra made me horribly depressed and even suicidal. I had to switch neurologists, because the doctor who prescribed it to me denied that it has any side effects. The new neurologist assured me that what I was experiencing was, in fact, a serious side effect of Keppra.

He was determined to find an anticonvulsant that I could tolerate. I went from Keppra to Zonagran to Lamotrigine and finally to Lamectal, which I stayed on for the remainder of the two-year post-seizure period. Each time I switched, my doctor wanted me to stay on the new drug for at least two months.

I would have stayed on Lamotrigine except that it gave me dangerously low sodium levels. It turns out that hyponatremia is a life-threatening condition. As soon as we figured out there was a problem, I came off of it right way.

Please make sure they are monitoring your boy friend’s sodium levels. If his energy levels start plummeting and he becomes drowsy and fatigued, something could be terribly wrong.

Hi Oak!

Thank you so much for taking the time out to respond to me! I’m so sorry about your experiences. I’m new to this process, and am only just dipping my toes into fully understanding his medical history and realizing that there might be some gaps in his care. As someone who has always trusted doctors to know the best, especially for anything so complex, it’s kinda startling to see that sometimes doctors can ignore what you’re saying and not take your own word in consideration.

Today is Day 11 or so I think on Lamotrigine for my boyfriend and he is definitely feeling more tired. Thanks for the tip on keeping an eye on his sodium levels. We’ll get a test done - do you think once every 3 months is good or would you recommend more/less? He’ll also bring this up to his doctor next time he goes.

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Dear Kanika,

I am not a health care professional. So, unfortunately, I cannot advise you. If it were me or my loved one, and the fatigue was getting worse, not better, I would play it safe and not wait to call the doctor. As I said, hyponatremia can be dangerous. A simple blood test can tell if your boyfriend’s sodium levels are dropping.

I am praying for peace, safety and healing :heart:


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My daughter did horribly on keppra.
She switched to lamogine. Took a few days/week? For her to adjust , but no major side effects.

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