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Epilepsy

The correct medication blood level

03/26/2009

Question:

As a military veteran who sustained an injury to my head which resulted in me having constant (at least 3 weekly)grand mal seizures, over the years I have tried all kinds of natural pathic remedies on my own. In an attempt to try and take control of my situation, from time to time, I have gotten completely off of my (dilantin 100mg 3 times a day and my phenobarbital 32mg 3 times a day), only to have to resort back to it. As I continue to educate myself, I will try reasonable things to try and better my life. My question is two fold. How long does it take to get the aforementioned drugs out of my system and how long does it take for me to get it back into my system to a reasonable or proper level.

Answer:

First, I want to emphasize how dangerous it can be to go off and on medication without medical supervision. Stopping medication is a cause of status epilepticus, a condition of continuous seizures that can permanently injure brain cells and may even cause death in a small percent of cases. Dilantin takes about 2-3 weeks and Phenobarbital about 3 weeks to fully clear from the blood. Each of the drugs can be back in the system within hours of taking by mouth (or minutes by vein) but will take weeks to reach "steady state". If side effects of the medications are a problem, you should discuss with your doctor trying one of the newer antiepileptic drugs that generally cause fewer side effects and have fewer drug-drug interactions. These medications can be found on the website: www.epilepsyfoundation.org.

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Response by:

Michael   Privitera, MD Michael Privitera, MD
Professor of Neurology
College of Medicine
University of Cincinnati