Lamotrigine--a clinical overview

Data from five almost identical protocols have been pooled to give the results of treatment with lamotrigine in 285 children with refractory epilepsy. All the children received lamotrigine as open, add-on therapy and efficacy was assessed after the first 12 weeks of maintenance dosage. More than 50% reduction in seizures was achieved for over 30% of patients with complex partial, secondary generalized tonic-clonic, myoclonic, primary generalized tonic-clonic and atonic seizures; and, more than 50% of those with typical or atypical absences. In children treated for more than a year, there was no evidence of development of tolerance. Evaluations by investigators and parents found lamotrigine to improve the child globally in 74% of cases. Lamotrigine was well tolerated. Dizziness, unsteadiness and other non-specific side-effects that have been noted in a small minority of adults were rarely complained of by children. Rash was the most frequently reported side effect, leading to withdrawal of the drug in 7.4% of patients. However, the rate was lower when lamotrigine dosage was increased slowly as recommended. Data from other, smaller trials have also been reviewed and it is concluded that lamotrigine is a very well tolerated drug with a broad spectrum of efficacy.