Lamotrigine as add-on therapy in children with drug-resistant epilepsy [Iranian experience]

ABSTRACT

Lamotrigine [LTG], a newly developed antiepileptic drug [AED], is efficacious in treating refractory epilepsy. This study was designed to evaluate the efficacy and safety of LTG as add-on therapy in 40 children with refractory epilepsy. The trial was an open-labeled prospective study in children with drug-resistant epilepsy aged <14 years, who had at least 4 seizures per month in spite of receiving at least 3 AED's. Initial LTG dose and titration was adjusted based upon the AED's which were taken simultaneously. Lamotrigine was increased in steps to maximal dose within 4 weeks and maintained for 3 months while pre-existing AED's remained unchanged. Overall efficacy was defined if>50% reduction of seizure frequency was achieved during 3 months follow up. Hematological and biochemical parameters were checked before and after the trial in all patients. The evaluation of drug safety consisted of chart review for treatment-emergent adverse events. Among 40 patients who completed the trial, 21 of them [52.5%] had >50% reduction in seizure frequency. Lamotrigine was effective in all seizure types, particularly typical absence. Lennox-Gastaut syndrome also responded well. Skin rashes occurred in 5 patients [10.6%] and resulted in LTG discontinuation. No significant changes were noted in laboratory results. These results indicated that LTG is well tolerated and is effective in controlling a variety of seizure types, especially absence epilepsy