Lamotrigine and epilepsy in the elderly: observational study of low-dose monotherapy

A one-year prospective, observational study was conducted in 222 elderly patients (>65 years old) with epilepsy. Patients received 25 mg/day lamotrigine for the first 15 days. The dose was then increased to 50 mg/day; further increases were allowed if necessary. Vascular epilepsy was the most frequent diagnosis (56% of patients), and concomitant medication was required by 75% of patients. The mean dose was 72.17 mg/day in the 132 patients who completed the study; the initial dose of 50 mg/day was maintained in 52% of these patients. There was a marked reduction in the number of seizures with 89% of the patients who completed the study continuing to be seizure-free after 1 year. Tolerability was generally good with 15 adverse events in nine patients. Only two patients developed a rash. In conclusion, low-dose lamotrigine is an effective and well tolerated therapy for the control of epilepsy in elderly patients.