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Tablets. Because of the bitter taste, tablets should not be broken. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. For Medication Guides, please visit www. You should avoid drinking when taking topiramate. talf.info vivitrol

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Call your doctor if your seizures get worse or you have them more often while taking topiramate. Topamax is used during pregnancy. This medication may decrease milk production. Forty-nine percent of subjects had no prior AED treatment and 17% had a diagnosis of epilepsy for greater than 24 months. Any AED therapy used for temporary or emergency purposes was discontinued prior to randomization. Since topiramate is presumed to undergo significant tubular reabsorption, it is uncertain whether this experience can be generalized to all situations of renal impairment. It is conceivable that some forms of renal disease could differentially affect glomerular filtration rate and tubular reabsorption resulting in a clearance of topiramate not predicted by creatinine clearance.

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Epilepsy Foundation web site. Consult your doctor before -feeding. Approximately 21% of the 159 adult patients in the 400 mg per day group who received topiramate as monotherapy in Study 1 discontinued therapy due to adverse reactions. Tablets to phenytoin may require an adjustment of the dose of phenytoin to achieve optimal clinical outcome.

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George, P. M. Plasma and urine betaine and dimethylglycine variation in healthy young male subjects. Clin Biochem. The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Dizziness can increase the risk of falling. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment. What should I know regarding pregnancy, nursing and administering Topamax to children or the elderly?



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Tell your doctor when you start any new drug, and discuss if you should use additional reliable birth control. Also tell your doctor if you have any new spotting or breakthrough bleeding, because these may be signs that your birth control is not working well. Maryanoff, BE; Costanzo, MJ; Nortey, SO; Greco, MN; Shank, RP; Schupsky, JJ; Ortegon, MP; Vaught, JL 1998. "Structure-activity studies on anticonvulsant sugar sulfamates related to topiramate. Enhanced potency with cyclic sulfate derivatives". Journal of Medicinal Chemistry. Maryanoff, S. O. Nortey, J. F. Gardocki, R. P. Shank, and S. P. Dodgson, "Anticonvulsant O-alkyl sulfamates. Overdoses of topiramate resulted in signs and symptoms which included convulsions, drowsiness, speech disturbance, blurred vision, diplopia, mentation impaired, lethargy, abnormal coordination, stupor, hypotension, abdominal pain, agitation, dizziness and depression. The clinical consequences were not severe in most cases, but deaths have been reported after polydrug overdoses involving topiramate. Most people have more than one of these “episodes” of dramatic mood shifts. There can be a long period of time without problems in between those mood swings. Due to an increased risk for problems, people with certain such as Alpers-Huttenlocher syndrome should not use this medication. Children younger than 2 years who might have these disorders should not use this medication. Children older than 2 years who might have these disorders should be closely monitored during treatment with sodium. Talk to your doctor for details. She reportedly breastfed her infant exclusively for 8 months at which time no adverse drug effects or neurodevelopmental delay were noted by the infant's pediatrician. Octreotide. This drug is a lab-made form of somatostatin, a growth hormone. You take it through an IV in your vein. Ghyczy, M. Endogenous phospholipid metabolite containing topical product inhibits ultraviolet light-induced inflammation and DNA damage in human skin. If you are taking hormonal such as pills, patch, or ring with this medication, tell your doctor if you have any new spotting or breakthrough bleeding. DailyMed. Torrent Pharmaceuticals Limited. Wendel, U. Psychotic symptoms in severe MTHFR deficiency and their successful treatment with betaine. Eur. Hold the capsule upright over the food.



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Shapira NA, Goldsmith TD, McElroy S. Treatment of binge disorder with topiramate: a clinical case series. J Clin Psychiatry. The conclusion that topiramate is effective as initial monotherapy in pediatric patients 2 to less than 10 years of age with partial onset or primary generalized tonic-clonic seizures was based on a pharmacometric bridging approach using data from the controlled epilepsy trials described in labeling. This approach consisted of first showing a similar exposure response relationship between pediatric patients down to 2 years of age and adults when topiramate was given as adjunctive therapy. Similarity of exposure-response was also demonstrated in pediatric patients ages 6 to less than 16 years and adults when topiramate was given as initial monotherapy. Lennox-Gastaut syndrome in adults and children 2 years of age and older. Avoid drinking alcohol. It can increase certain side effects of topiramate, and can also increase your risk of a seizure. Honestly, they weren't taken seriously back then. I noticed that every time I perspired after doing any kind of work I would get a migraine. My activities were extremely limited and it affected me as a mom. I missed a LOT of my kids' games because there was no migraine medication that worked. I now use a very effective migraine medicine Zomig that works after the migraine has started, but I only get 9 pills per month. This medication has greatly reduced the number of migraines I get and I have migraine pills leftover at the end of the month. I still get migraines, but they are much less severe and far less frequent. I can exercise now without fearing the heat will cause a migraine. I will never get those events back that migraines took me away from, but now I know my future looks great. It didn't work overnight, but it didn't take long to take effect. Maybe a week. I'm very happy. Unfortunately, I have passed my migraine "gene" to my daughter who is 28 and this medication does NOT help her. Oligohydrosis decreased sweating resulting in hospitalization in some cases, has been reported in association with topiramate use. Decreased sweating and an elevation in body temperature above normal characterized these cases. Some of the cases were reported after exposure to elevated environmental temperatures. Topiramate sprinkle capsules comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get topiramate sprinkle capsules refilled. Topiramate is quickly absorbed after oral use. Most of the drug 70% is excreted in the urine as unchanged drug. What is clear, however, is that epilepsy drugs should at least be considered for discontinuation in patients who are seizure-free for 10 years. If a medication is going to be discontinued, it should be weaned gradually to avoid triggering a seizure. Co-administration of diltiazem 240 mg with topiramate 150 mg per day resulted in a 10% decrease in C max and 25% decrease in diltiazem AUC, 27% decrease in C max and 18% decrease in des-acetyl diltiazem AUC, and no effect on N-desmethyl diltiazem. Co-administration of topiramate with diltiazem resulted in a 16% increase in C max and a 19% increase in AUC 12 of topiramate. If you are less than 6 hours late in taking your medicine, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. In open-label, uncontrolled experience, increasing impairment of adaptive behavior was documented in behavioral testing over time in this population. There was a suggestion that this effect was dose-related. Alfthan G, Tapani K, Nissinen K, et al. The effect of low doses of betaine on plasma homocysteine in healthy volunteers. Letmaier, M; Schreinzer, D; Wolf, R; Kasper, S 2001. “Topiramate as a mood stabilizer”. International clinical psychopharmacology. Tablets and alcohol can affect each other causing side effects such as sleepiness and dizziness. olanzapine



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Numerous AEDs are substrates of the CYP enzyme system. Tablets are contraindicated in patients with a history of hypersensitivity to any component of this product. Your doctor may need to adjust your medication during treatment with this medication. In all add-on trials, the reduction in seizure rate from baseline during the entire double-blind phase was measured. Read the Guide provided by your before you start taking and each time you get a refill. If you have any questions, ask your doctor or pharmacist. Take Topiramate tablets exactly as prescribed. Chong MS, Libretto SE. The rationale and use of topiramate for treating neuropathic pain. Clin J Pain. Your pill pack contains 21 pills with active medication. It may also contain 7 reminder pills with no medication. Take one active pill with hormones once daily for 21 days in a row. If you are using a product with 28 tablets, take an inactive pill once daily for 7 days in a row after you have taken the last active pill unless otherwise directed by your doctor. If you are using a product with 21 tablets, do not take any tablets for 7 days unless otherwise directed by your doctor. You should have your period during the fourth week of the cycle. After you have taken the last inactive tablet in the pack or gone 7 days without taking an active tablet, start a new pack the next day whether or not you have your period. If you do not get your period, consult your doctor. Kudin AP, Debska-Vielhaber G, Vielhaber S, Elger CE, Kunz WS December 2004. The risk of suicidal thoughts or behavior was generally consistent among drugs in the data analyzed. The finding of increased risk with AEDs of varying mechanisms of action and across a range of indications suggests that the risk applies to all AEDs used for any indication. The risk did not vary substantially by age 5 to 100 years in the clinical trials analyzed. Other surgical approaches are reserved for specific types of epilepsy and are most often performed in young children. Topiramate Extended-Release Capsules may make your birth control pills less effective. Tell your healthcare provider if your menstrual bleeding changes while you are taking birth control pills and Topiramate Extended-Release Capsules. Hahn, MK; Cohn, T; Teo, C; Remington, G January 2013. “Topiramate in schizophrenia: a review of effects on psychopathology and metabolic parameters. store suprax guidelines suprax



Topiramate forms and strengths

In some cases your doctor may prescribe a medicine such as a or to stop a if nonprescription medicines don't work. But these drugs can be habit-forming and should be used rarely and only for a short time. Heiss, G. Usual choline and betaine dietary intake and incident coronary heart disease: the Atherosclerosis Risk in Communities ARIC study. BMC. And make sure your doctor knows about all other drugs you take. There isn't a strict rule about this, and it varies with each child. Usually, doctors will try different epilepsy drugs at different doses to determine the best one for your child. Your child should take just enough medicine to prevent seizures without causing side effects. You and your child's doctor may need to tinker with the prescription over a few months to find the right dose. It's worth the effort. Too much medication increases the side effects, while too little leaves your child vulnerable to seizures. Frosst P, Blom HJ, Milos R, et al. A candidate genetic risk factor for vascular disease: a common mutation in methylenetetrahydrofolate reductase. Talk with the doctor about the risks and benefits of using this medication in children younger than 2 years. purchase cheapest acarbose shop



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What should I discuss with my healthcare provider before taking topiramate Topamax? At a dosage of 50 mg twice per day, topiramate reduced migraine frequency by approximately two headaches per month compared with a reduction of one headache per month with placebo. Multiple dosing of topiramate 150 mg per day in healthy volunteers did not affect the pharmacokinetics of venlafaxine or O-desmethyl venlafaxine. Multiple dosing of venlafaxine 150 mg did not affect the pharmacokinetics of topiramate. Although appropriate studies on the relationship of age to the effects of topiramate have not been performed in the geriatric population, geriatric-specific problems are not expected to limit the usefulness of topiramate in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving topiramate. The capsules may either be swallowed whole or opened and sprinkled over a spoonful of soft food, such as applesauce, custard, ice cream, oatmeal, pudding, or yogurt. Do not crush or chew the beads inside the capsule. In controlled clinical trials in adults, 11% of patients receiving topiramate 200 to 400 mg per day as adjunctive therapy discontinued due to adverse reactions. This rate appeared to increase at dosages above 400 mg per day. Adverse events associated with discontinuing therapy included somnolence, dizziness, anxiety, difficulty with concentration or attention, fatigue, and paresthesia and increased at dosages above 400 mg per day. The majority of the reports have been in children. Patients, especially pediatric patients, treated with topiramate should be monitored closely for evidence of decreased sweating and increased body temperature, especially in hot weather. Caution should be used when topiramate is prescribed with other drugs that predispose patients to heat-related disorders; these drugs include, but are not limited to, other carbonic anhydrase inhibitors and drugs with anticholinergic activity. No patients discontinued treatment due to any adverse events in the adjunctive epilepsy double-blind trials. In the monotherapy epilepsy double-blind trial conducted with immediate-release topiramate product, 1 pediatric patient 2% in the 50 mg per day group and 7 pediatric patients 12% in the 400 mg per day group discontinued treatment due to any adverse events. Six have been identified in humans, none of which constitutes more than 5% of an administered dose. What happens if I miss a dose Topamax? Study 1 was conducted in 487 patients diagnosed with epilepsy 6 to 83 years of age who had 1 or 2 well-documented seizures during the 3-month retrospective baseline phase who then entered the study and received topiramate 25 mg per day for 7 days in an open-label fashion. Forty-nine percent of subjects had no prior AED treatment and 17% had a diagnosis of epilepsy for greater than 24 months. Any AED therapy used for temporary or emergency purposes was discontinued prior to randomization. In the double-blind phase, 470 patients were randomized to titrate up to 50 mg per day or 400 mg per day of topiramate. If the target dose could not be achieved, patients were maintained on the maximum tolerated dose. Fifty eight percent of patients achieved the maximal dose of 400 mg per day for greater than 2 weeks, and patients who did not tolerate 150 mg per day were discontinued. Tuma, D. J. The effect of betaine in reversing alcoholic steatosis. STEPS drug updates cover Safety, Tolerability, Effectiveness, Price, and Simplicity. Each update provides an independent review of a new medication by authors who have no financial association with the drug manufacturer. Concomitant administration of topiramate and valproic acid has been associated with hyperammonemia with or without encephalopathy in patients who have tolerated either drug alone. Topiramate did not demonstrate genotoxic potential when tested in a battery of in vitro and in vivo assays. Topiramate was not mutagenic in the Ames test or the in vitro mouse lymphoma assay; it did not increase unscheduled DNA synthesis in rat hepatocytes in vitro; and it did not increase chromosomal aberrations in human lymphocytes in vitro or in rat bone marrow in vivo. Evaluation of effectiveness and safety in clinical trials has shown no race or gender related effects.



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When topiramate replaces another antiepileptic drug, the dose of the other antiepileptic should be reduced gradually at the rate of approximately one-third of the dose every 2 weeks while initiating topiramate therapy. When an enzyme-inducing drug is discontinued, topiramate levels may increase and a decrease in the topiramate dosage may be required. Cipriani, A; Barbui, C; Salanti, G; Rendell, J; Brown, R; Stockton, S; Purgato, M; Spineli, LM; Goodwin, GM; Geddes, JR 8 October 2011. “Comparative efficacy and acceptability of antimanic drugs in acute mania: a multiple-treatments meta-analysis. Store at room temperature away from moisture and heat. Do not freeze the liquid form of this medicine. Tell your healthcare provider right away if you become pregnant while taking Topiramate Extended-Release Capsules. You and your healthcare provider should decide if you will continue to take Topiramate Extended-Release Capsules while you are pregnant. Contact your doctor if your seizures get worse or you have them more often while taking Vimpat. You should not use topiramate if you are allergic to it. Do not take Trokendi XR within 6 hours before or 6 hours after drinking alcohol. You should not use extended-release topiramate if you have metabolic acidosis high levels of acid in your blood and are also taking metformin for diabetes. Clinical studies of immediate-release topiramate did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently than younger subjects. Psych-Can cause ataxia, impaired psychomotor function, syncope, and increase risk for additional falls in those predisposed. Vision-Visual field defects have been reported in patients receiving topiramate independent of elevated intraocular pressure. In clinical trials, most of these events were reversible after topiramate discontinuation. Tablets may cause eye problems. Hahn, MK; Cohn, T; Teo, C; Remington, G January 2013. "Topiramate in schizophrenia: a review of effects on psychopathology and metabolic parameters. rizatriptan how to buy online



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Tablets. If you would like more information, talk to your healthcare provider. Read the Medication Guide provided by your pharmacist before you start taking topiramate and each time you get a refill. If you have any questions, ask your doctor or pharmacist. The drug is also used to treat migraines due to the effect it has on the blood vessels in the brain. It has been found to be increasingly effective for migraine sufferers with limited side effects. Topiramate may cause other side effects. Call your doctor if you have any unusual problems while taking this medication. These treatments aim to stop cluster headaches from happening. You take them at the start of an episode. Topiramate is not extensively metabolized and is primarily eliminated unchanged in the urine approximately 70% of an administered dose. Six metabolites have been identified in humans, none of which constitutes more than 5% of an administered dose. The metabolites are formed via hydroxylation, hydrolysis, and glucuronidation. There is evidence of renal tubular reabsorption of topiramate. In rats, given probenecid to inhibit tubular reabsorption, along with topiramate, a significant increase in renal clearance of topiramate was observed. This interaction has not been evaluated in humans. Tablets suddenly can cause serious problems. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip themissed dose and resume your usual dosing schedule. Doses greater than or equal to 50 mg should be administered as 2 divided doses. You should not use Vimpat if you are allergic to lacosamide. Another study recommends topiramate as an effective treatment in the prevention of in preterm infants after an - injury. You may need to stop this medication for a time or take special precautions. Paresthesia usually tingling of the extremities an effect associated with the use of other carbonic anhydrase inhibitors, appears to be a common effect of topiramate in adult and pediatric patients. Paresthesia was more frequently reported in the monotherapy epilepsy trials conducted with immediate-release topiramate than in the adjunctive therapy epilepsy trials conducted with the same product. The information contained in the Truven Health Micromedex products as delivered by Drugs. Bertone, M. S. Evaluation of the efficacy and tolerability of a solution containing propyl betaine and polihexanide for wound irrigation. Johannessen SI, Helde G, Brodtkorb E. Levetiracetam concentrations in serum and in breast milk at birth and during lactation. Epilepsia. buy hyzaar miami hyzaar



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Tell your healthcare provider about any side effect that bothers you or that does not go away. Use extra care not to become overheated during exercise or hot weather with topiramate. Overheating may result in heat stroke and hot baths or saunas may make you dizzy or feel faint. Topiramate may increase the plasma-levels of phenytoin. If you miss a dose, take it as soon as you remember. If it is within 6 hours of your next dose, skip themissed dose and resume your usual dosing schedule. not double the dose to catch up. If you miss more than one dose, call your doctor for advice. Multiple myeloma can be painful. Cancer cells may build up in your bone marrow and put pressure on bones, nerves, muscles, or other tissues in different parts of your body. The disease also damages bones, which can cause pain, too. The pain can last for a short time, or you could have long-lasting pain. Because of the bitter taste, tablets should not be broken. Topiramate has anticonvulsant activity in rat and mouse maximal electroshock seizure MES tests. Topiramate is only weakly effective in blocking clonic seizures induced by the GABA A receptor antagonist, pentylenetetrazole. Topiramate is also effective in rodent models of epilepsy, which include tonic and absence-like seizures in the spontaneous epileptic rat SER and tonic and clonic seizures induced in rats by kindling of the amygdala or by global ischemia. Tell your doctor if you just had or will be having surgery or if you will be confined to a bed or chair for a long time such as a long plane flight. Make sure you know how you or your child react to topiramate before you drive, use machines, climb in high places, swim, or do anything else that could be dangerous if you are not alert, well-coordinated, or able to think or see well. seroflo



Dizziness can increase the risk of falling

In studies of healthy volunteers, comparing the two medications, therapeutic doses of topiramate for bipolar disorder produced greater cognitive deficits than lamotrigine, including short term memory loss and word-finding difficulty. This effect has led to the occasional use of the name "dopamax" by some dissatisfied customers. McClain, C. Nonalcoholic fatty liver disease: predisposing factors and the role of nutrition. J Nutr Biochem. If you have any problems, talk to your doctor about your options. Topiramate may be given without regard to meals. There are no studies using topiramate in pregnant women. Topiramate should be used during pregnancy only if the potential benefit outweighs the potential risk to the fetus. Immediate-release topiramate does not influence the binding of sodium valproate. Wilding J, Van Gaal L, Rissanen A, Vercruysse F, Fitchet M; OBES-002 Study Group. A randomized double-blind placebo-controlled study of the long-term efficacy and safety of topiramate in the treatment of obese subjects. Int J Obes Relat Metab Disord. It may harm an unborn baby. Discuss the use of reliable forms of with your doctor. If you become or think you may be pregnant, tell your doctor right away. You will need to have a negative before starting this medication. You will also need to take a pregnancy test every month while on this medication. Follett, PL; Deng, W; Dai, W; Talos, DM; Massillon, LJ; Rosenberg, PA; Volpe, JJ; Jensen, FE 2004. "Glutamate receptor-mediated oligodendrocyte toxicity in periventricular leukomalacia: a protective role for topiramate". Journal of Neuroscience. When and how much you take depend on how long yours usually last and how often you get them. Work with your doctor to find the best schedule for you. Balcells, S. Molecular characterization of five patients with homocystinuria due to severe methylenetetrahydrofolate reductase deficiency. Clin Genet. Topiramate has not been directly compared with other anti-epileptic drugs, tricyclic antidepressants, or calcium channel blockers. However, one study included propranolol Inderal as an active control. NOTE: For QUDEXY XR R and its generic forms the capsule may be swallowed or opened and sprinkled on a spoonful of soft food. TROKENDI XR R capsules are hard and must be swallowed whole and not chewed, crushed, or sprinkled on food.



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Prescribing information for topiramate

Topiramate is cleared by hemodialysis at a rate that is 4 to 6 times greater than a normal individual. Accordingly, a prolonged period of dialysis may cause topiramate concentration to fall below that required to maintain an anti-seizure effect. To avoid rapid drops in topiramate plasma concentration during hemodialysis, a supplemental dose of topiramate may be required. This medication has rarely caused severe sometimes fatal disease of the pancreas pancreatitis. This may occur at any time during treatment and can quickly worsen. When Topiramate Extended-Release Capsules are added to pioglitazone therapy or pioglitazone is added to Topiramate Extended-Release Capsules therapy, careful attention should be given to the routine monitoring of patients for adequate control of their diabetic disease state. generic ranolazine efficacy

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Table 8 also presents the incidence of adverse reactions occurring in at least 1% of pediatric patients treated with topiramate and occurring with greater incidence than placebo. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended. Kramer, CK; Leitão, CB; Pinto, LC; Canani, LH; Azevedo, MJ; Gross, JL May 2011. "Efficacy and safety of topiramate on weight loss: a meta-analysis of randomized controlled trials. decadron price in dubai

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Because your muscles are relaxed, the seizure will probably only slightly move your hands and feet. Your doctor will watch you carefully during the treatment. As of August 17, 2001 there have been 23 reported cases: 22 in adults and 1 in pediatric patients. It is generally recognized that postmarketing data are subject to substantial under-reporting. Turnhoutseweg 30, B-2340 Beerse, Belgium. They help with mild to moderate pain. cefixime

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Idiosyncratic side effects. These are rare and unpredictable reactions which are not dose-related. Gentile S. Topiramate in pregnancy and breastfeeding. Clin Drug Investig. So your doctor may not want you to take it if you're pregnant. In pediatric patients 6 years to 15 years of age the incidence of persistent treatment-emergent decreases in serum bicarbonate in the epilepsy controlled clinical trial for monotherapy performed with topiramate was 9% for 50 mg per day and 25% for 400 mg per day. Additional nonspecific CNS events commonly observed with topiramate in the add-on epilepsy population include dizziness or ataxia.

Before having surgery, tell your doctor or dentist about all the products you use including prescription drugs, nonprescription drugs, and herbal products. In some types of epilepsy, patients can be taken off treatment after a few years, while other types of epilepsy require lifelong treatment. With few exceptions, patients who are seizure-free for a certain period should be re-evaluated to determine whether the drug can be discontinued. How long the seizure-free period should be varies among the types of epilepsy and is controversial even for a given type. The decision to discontinue a medication also depends on more than the length of the seizure-free period.

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