Hi,

I understand your concern. This is extremely sensitive question to answer on this forum. Although there are set guidelines and treatment protocols any child requires a tailor made treatment. A physician starts an epileptic with lowest possible dose and timely verify the clinical condition to increase / decrease it. The dosage of lamotrigine varies a lot from child to child especially when the child is already on Valproate. The dose differs whether it is Xtended release(XR) or oral dis integration or chewable forms.

The dose that your child receives now is standard (I guess it is XR) and I do not think it is appropriate to comment any more about dose without actuals of the medical history and examination. The doctor critically assess the condition and takes the decision in the favor of your child's benefit. Believe me all these anti epileptics have very narrow safety spectrum. A higher dose or a lower dose both can induce grand mal seizures.

Finally if the clinician is unable to control the seizures it is appropriate to take a second opinion from different Pediatric Epilepsologist about the course of treatment rather than the dose of it.

Hope I could throw some light on it and make you understand the sensitive nature of the such questions on this educational forum.

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As standard recommendations are 1-3mg/kg/day along with valproic acid, there seems to be a room for increase in the dose if the seizures are uncontrolled. There is a thought to increase up to 50% as maintainance. Since your child is still receiving the therapeutic dose let the doctor decide to increase it.

Please remember not to take any decision without consulting your treating doctor.

Thank you.

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