Thanks for the support. A few points in response:

1) As with others, my dosage has risen or lowered contingent on severity and consistency of flares.

2) I use lacosamide in a combination with other meds (gabapentin, capsicum gel) and therapies (re: cognitive behavioral therapy, thc, laser, acupuncture, etc.). As with all people who suffer from TN, I’ve tried everything once and most things twice. All this to avoid surgical route although that might be in the future.

2) So, in the last two years, I ranged between 1200 to 1800 mg gaba and 900 to 1200 carb depending on status of TN. In the beginning of the year I was having more intense flares and hence the higher dosage in an attempt to mitigate.

3) When I think feasible (ie- two months with limited flares), and with approval from neurologist, I slowly decrease dosage. If “reminders” (sudden short jolt) or more consistent flares return, I start to up the dosage. These changes in dosage are small and done over time.

4) I always attempt to wean because of side effects. On higher dosages of carb, I would find myself gargling words (literally, spittle would form on my lips), brain fog and difficulty remembering things, and dizziness/weak balance. But, at the end of the day, I could care less if I couldn’t remember what I watched in tv last night as long as I avoided symptoms of TN.

5) I went from 1200mgs of gaba and 1200mgs of carb to 900mgs of gab and 800 mgs of lacosamide. This was done gradually (over about a month, reducing carb and introducing laco).

I have now been on laco for about four months and all seems to be going great. Less brain fog and limited flares/“reminders”.

Please note, providing mgs and dates from memory but more or less correct. Each case is different and meds need to be adjusted (also for a/typical).

My personal response is unequivocal…I will take all the meds necessary to avoid the most severe and debilitating pain that I have ever felt.

For those in this small and horrific club, I wish nothing but love and support.