hobart logo
A Medication Guide photo

Uses for This Medication: To fix your brain that you thought was fixed already, but not so much. You thought your brain was healed when you survived four brain surgeries at age 37 to remove a rare malformation, that time you spent several weeks in the neuro ICU followed by physical, occupational, and behavioral health therapy. But that was just the start of your trouble-free recovery. The side effect of scar tissue in your “fixed” brain is seizures, and the real fun begins now, with this prescription for Anti-Seizure Medications, the medication regimen that can’t be undone, that’s really pleasant, and not disruptive to your life or your family’s. Don’t worry about a thing.

Before Using This Medication, Tell Your Doctor:

  • If you have any allergies or other diseases. But he (she) should already know this information. It’s in your files, or he detected it when he dug inside your brain with his neurosurgeon tools and flashlight. When he located the section of the brain labeled “Allergies,” it read “None.”
  • If your relationships, like your marriage, are fragile (i.e., more than a year in, past the honeymoon phase when shit gets real, when you are always too tired for sex, when your job or kids or other obligations demand more time than you have for each other, when you have no idea what to prepare for dinner).
  • If your kids (ages seven and four) want their normal mom back, their nice mom, who used to answer willingly during the million times a day when they yelled, “Mooooooooommmm!”
  • If your family is still in shock from your first seizure, when your husband found you naked and convulsing on the bathroom floor, banging your head between the porcelain toilet and the glass shower door, and thought you were dying.
  • If your family is confused by the timing of that seizure, which occurred four months after your surgeries, when you were finally moving around comfortably sans icepack on your head, eating more than applesauce and oatmeal, sleeping upright on a pillowcase not stained with blood, showering unattended, and when the swelling had gone down enough so that your right eye no longer marked the center of your face.

How this Medicine Works:

  • It aims to “calm the brain” by preventing nerve cells from hyperactivity without interrupting regular brain activity. Something about a synaptic neurotransmitter. You won’t really understand. 
  • While this medicine intends to stabilize the electrical misfires in your brain, under certain circumstances, it may result in misfires elsewhere in your life.

How to Use:

  • Use this drug as ordered by your doctor. Your doctor has literally put his hands inside your brain and removed a piece of it, a bloody, sticky, spongy piece that could have killed you. Surely, he’s the expert.
  • Take orally. Swallow with plenty of water because the pills are horse-size and you’ll take several, twice a day. You’ll take the white ones, the highest dose. The orange ones weren’t strong enough, the yellow and blue ones, laughable. They couldn’t stop a seizure in an ant. Take only the giant white ones.
  • Do not miss doses because the abnormal electrical activity in your brain that the medication prevents could fire up again. You could injure yourself or others; someone might die. But you’d be too out of it to know, probably in the ICU again. Although they’d probably put you in the nice room with the extra machines and special nurses who monitor your every breath, every heartbeat, every brain wave. You’re that sick.
  • Even though your doctor removed most of your right temporal lobe in the surgeries, the part of the brain involved in learning, remembering non-verbal information, and memory, and it will take years for your brain to recover, take the medicine anyway, even when you can’t remember. Set alarms or beg your fairy godmother to appear and help you magically remember before midnight, when you might turn back into a seizure ball on the floor. 
  • If you miss a dose, do NOT mention to your spouse (caretaker or partner) because:
    • He (she) may rush home to find you seizing, either alone or with your young children unattended because you are unconscious. OR
    • He may find you at home cooking dinner, folding laundry, playing with your children, or scrolling through your phone when your children are playing nicely without your attention, and then be angry that he rushed home. “Are you kidding me? You scared the shit out of me.” he’ll say. You’ll cry.
    • In either situation, he does not understand, though may try to, that your brain is overwhelmed and simple tasks sometimes require maximum effort (e.g., completing a sentence with the words in the correct order, remembering to feed the dog, or remembering that he said he fed the dog when you accidentally fed her again). No one knows what it feels like except you. 
    • Your spouse does not like the reminder that you are unwell. He rushed out of an important meeting at work to ensure your safety. You weren’t fine last time, but this time, you are fine. 

Side Effects and Risks:

  • The most common side effect is extreme fatigue and the most dangerous side effect is rage. Scientific studies define it as “feeling irritable.” You’ll come to know it as uncontrollable wrath from the devil, followed by sadness and regret.
  • Your family will recognize the change, and they will resent your constant negativity and crying. Your husband will repeatedly ask you to calm down, to stop yelling. And then he’ll ask why you’re crying. You’ll fake that you’re fine. You’ll press your palms to your forehead and try to hide your tears, but the snot all over your face requires multiple tissues – a dead giveaway that you can’t control your emotions.
  • When your kids ask why you like to sleep later than they do, sometimes causing their tardiness to school, you will respond in a demonic tone, “It’s the stupid medicine. Now get in the car and stop asking!” You’ll slam the car door shut, narrowly missing their fingers and toes.
  • When you are short-tempered (always), you may engage in more physical aggression. 
  • You will punch the washing machine doing the hundredth load of laundry for the week. Your knuckles will bleed. You will scour the house for band-aids with your hand wrapped in a towel. You don’t want anyone to notice the droplets of blood. You’ll wash that towel again anyway.  Throw it back in the dirty pile.
  • Running late for school, you’ll punch the visor in your car, breaking the right-side hinge. The visor will never adequately close again. Your children will feel like they did something wrong and ask questions about it from the back seat. “Did we make you do that? Sorry, mom,” they’ll say. You will hate yourself. They won’t notice the chipped paint off the front door that you kicked open after drop off that day, but your spouse will. “Is it really worth taking the medication if it’s going to make you act like this?” You won’t know how to respond.


  • The most critical factor for brain healing and medication effectiveness is sleep. You must attempt to balance the health and well-being of your children and yourself. You’ll likely put your children’s needs first, at the cost of sleep. Proceed with caution, however, as your lack of sleep will worsen your side effects and your ability to recover emotionally and physically. Remember to put on your oxygen mask first, your doctor advises politely, as if riding an airplane is the same as earthquakes inside your brain.
  • Your spouse will step-up and fill in for your deficits as a mom and wife, as you knew he would, that’s why you married him. You used to divide and conquer domestic duties in your marriage – you do the dishes while he oversees the kids’ bath time, and vice versa. Now when you have a bad day, he does both. You know that’s a lot to ask him to take on. When he traveled for work, you used to handle the domestic activities alone. It’s exhausting. You can’t fathom how single parents take this medication and parent alone. You realize you are an asshole for complaining about this medication at all. You’re lucky to have a partner.
  • And he provides the sole source of income for your family now. You quit your job to deal with the potentially deadly brain lesion. You are still recovering from that decision. Some days you regret it; other days, thankful. But now you know that you would not be able to sustain a career and parenthood, postoperatively. The stress was sometimes too much in your healthier condition. You frequently stayed up until 2am to meet client deadlines. Those types of hours would ruin you now. You’d likely throw your laptop out the window and yell at coworkers and clients, destroying your professional reputation permanently. 
  • This medication is not compatible with alcohol, so your family and friends will not only identify you as “recovering from brain surgeries, at-risk for seizures,” but also “grouchy, tired, no fun at all.”
  • When you gather with your high school and college friends for rare special occasions, everyone will drink and reminisce. You’ll just reminisce and feel bitter. Wine-nights with the elementary school moms won’t be a thing for you anymore. You can’t have a drink and pack the lunches and wake up in time. No one wants to hear how much your hair has grown back from your craniotomy incision site anyway.

Medication Return Policy:

  • None


image: Doug Paul Case