Archive for October, 2009
How can I save money on my Antiepileptic Drugs?
Answer by David G. Vossler, M.D.
Here are just some of the way for you and your healthcare provider to help you save money on antiepileptic medications (AEDs):
- Use the largest pill size available – multiple small pills cost lots more than one large pill
- Get a pill cutter at your pharmacy and cut large pills in half (if that is what your dose calls for). For example, if your dose of Topamax is 100 mg twice a day you could use the
100 mg tablet size, but it costs less to use half of a 200 mg tablet - Ask your provider if it is okay to use a generic, rather than brand name, AED
- Simplify dosing regimens: rather than use two tablet sizes of the same AED to achieve intermediate individual doses, consider cutting larger tablets in half. For example, if your dose of Trileptal is 450 mg twice a day, instead of using one 150 mg pill and one 300 mg pill to make 450 mg, you could take 1-1/2 300 mg tablets.
- If possible and indicated, ask your doctor about using the older generation AEDs
- Use 90-day mail-order pharmacies rather than monthly local pharmacies
- If you must pay cash, call local pharmacies and ask their retail prices. Shopping around can save you money.
Can Vaccines Cause Seizures?
Answer by Russel Saneto, DO, Ph. D.
The CDC reports that seizures are associated with immunizations about 1 in every 10,000 immunizations. DTP immunizations have a 2 – 3 fold increase in seizures on the day of immunization and MMR has a slight increase in seizures 1 – 2 weeks after immunization. It is the recommendation that all patients with epilepsy have immunizations by the CDC.
We usually tell parents to use Tylenol the day of immunizations with DPT to prevent fever.
There is one caveat to this. If a patient has a mutation in the SCN1A gene, then any fever can be very problematic. In one study out of Australia there were a significant percentage of children who developed seizures after immunization who had a mutation in this gene.
Fortunately, most children do not have this mutation. In those children with the SCN1A gene mutation, I usually give them extra medication before their immunization.
It would be far worse for anyone with epilepsy to develop any of these diseases with respect to any seizure event caused by the immunization itself. This is not so far fetched as this past year there was an outbreak of pertussis at our Hospital and within the region. To get a job at Children’s Hospital, every one has to be vaccinated against pertussis. This would show that even with the best prevention, exposure and disease are possible.
