VA Hopeful Dr

Senior Member
15+ Year Member
Jul 28, 2004
20,317
26,000
Status
Attending Physician
A question for my neurology colleagues. I'm a family doctor who just inherited a patient with epilepsy whose seizures are managed with phenobarbital. I've started her on Keppra with the hope of titrating her off of the phenobarb in 1 month but I have no idea what the safe method for doing that is. Does anyone here have a decent reference to help me out with this?
 

neglect

1K Member
15+ Year Member
Sep 2, 2003
8,838
2,641
CT
Visit site
Status
A question for my neurology colleagues. I'm a family doctor who just inherited a patient with epilepsy whose seizures are managed with phenobarbital. I've started her on Keppra with the hope of titrating her off of the phenobarb in 1 month but I have no idea what the safe method for doing that is. Does anyone here have a decent reference to help me out with this?
The patient may be doing just fine with the current regimen. I've learned the hard way that my idea of perfection can end up being worse than the current good.
 
OP
VA Hopeful Dr

VA Hopeful Dr

Senior Member
15+ Year Member
Jul 28, 2004
20,317
26,000
Status
Attending Physician
The patient may be doing just fine with the current regimen. I've learned the hard way that my idea of perfection can end up being worse than the current good.
She doesn't really like it, and I've literally never prescribed it and don't really feel comfortable monitoring it - and cash pay so no neurologist will see her
 

kchan99

15+ Year Member
Apr 21, 2004
305
86
Maryland
Status
Attending Physician
Have you considered referring her to a university clinic? Why no Obama care health insurance? In Ohio, larger medical centers offer HCAPS for patients who have too much income to qualify for Medicaid. Patients in HCAPS receive discounted care.