Quality of life improvement with conversion to lamotrigine monotherapy

This report describes the effect on patient-reported quality of life (QOL) after reduction from two drugs to monotherapy with lamotrigine. Patients taking lamotrigine (LTG) with an enzyme-inducing drug were converted to LTG monotherapy for a 12-week follow-up. Changes in QOLIE-31 between baseline and follow-up were compared with physicians' global change ratings and patient-reported health status. Total QOLIE-31 scores increased 10.7 points for patients rated by physicians as having mild improvement, and 17 points for those reported as having moderate to marked improvement. Subscale scores also increased by minimum important change (MIC) amounts (> or = 11.76), with the largest change in Cognition, Energy, Medication Effects, and Seizure Worry subscales. The data also support > or = 11 MIC as a clinically important change in total score for the QOLIE-31. Exploratory analyses also provide information about MIC for individual subscales (8-18 for physician rated global change, 10-26 for patient-rated global health status change). This study demonstrates the value of reduction to monotherapy from the patients' and physicians' perspectives.