We just went through a terrible experience with my son. Following thee advice of our neuro we went up on Zonegran every 7 days while going down on Depakote every 5 days trying to optimize our seizure controll. Long story short we ended up in the ER for 4 days and in the epilepsy unit for 8 days. Here are the lessons we learned so you won't suffer the same problems (most of this I already knew to some extent but I will never forget it no matter what the neuro advises in the future):
1. When changing your child's epilesy medication do so under the supervision of a doctor and whenever possible only change the amounts one medication at time. This requires a lot of patience but at least if something goes wrong (or right) you will have a better idea of why.
2. When reducing the amount of an epilepsy medication your child is taking do this under a doctor's supervision and only a little at a time. The time between reductions should typically be 5 times the half life of the drug your child is taking.
Half Life: the time it takes for the half of the amount of drug in the brain to be eliminated. This can easily be looked up on epilepsy.com
3. When increasing the amount of an epilepsy medication your child is taking do this under a doctor's supervision and only a little at a time. The time between increases should typically be a minimum of the time to steady state for the drug being increased once a theraputic dosage is reached.
Time to Steady State: the time it takes for the amount of drug entering the brain to equal the amount being excreted. This can easily be looke up on epilepsy.com
I cannot express how scary it was to have to take our child to the ER and to have him in the PICU for days (they don't put you in there for nothing). I will be even more CAREFUL in the future no matter how bad things seem with epilepsy it seems impatience can make them even worse!