Related Experiment Video
Updated: Apr 23, 2026

Author Spotlight: Obtaining High-Quality CSF and Blood Samples for Epilepsy Biomarker Discovery
Published on: September 1, 2023
Effect of comedication on lamotrigine clearance in Korean epilepsy patients
Hee-Jung Kim1, Tae-Eun Kim2, Eun Yeon Joo3
1Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Background:
Lamotrigine (LTG) is a widely used antiepileptic-drug (AED) for the treatment of epilepsy. We investigated the effect of AED comedication on LTG clearance in Korean patients with epilepsy.
Methods:
The authors reviewed the medical charts for all patients≥18years who have received LTG as monotherapy or adjunctive therapy. Data collected included LTG levels, dosage, treatment duration, concomitant AEDs and specific side effects. LTG clearance was estimated according to comedication.
Results:
A total of 580 blood samples from 548 patients were analyzed. LTG clearance in the enzyme-inducing AED (EIAED) coadministration group was the highest (0.050l/kg/h), followed by the LTG monotherapy group (0.028l/kg/h), the coadministration group of both valproate (VPA) and EIAED (0.024l/kg/h) and the VPA coadministration group (0.018l/kg/h). When LTG was administered with both VPA and EIAED, the multiple EIAED group had higher LTG clearance than the single EIAED group.
Conclusions:
Concomitant administration of valproate reduced LTG clearance by approximately 35%, while EIAEDs increased LTG clearance by 80%. These relationships indicate the importance of considering the effects of comedication on LTG clearance when determining LTG dosage.
Related Concept Videos
Pharmacokinetics in Pediatric Patients: Drug Excretion
Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
Antiepileptic Drugs: Potassium Channel Activators
Ezogabine has gained approval as an adjunctive treatment...
Therapeutic Drug Monitoring: Affecting Factors
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
Antiepileptic Drugs: Sodium Channel Blockers
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...

