[Adding lamotrigine to the treatment of epilepsy which is difficult to control]

We studied the effect of adding Lamotrigine to the medication of 36 patients with refractory epilepsy (ten with Lennox-Gastaut syndrome and ten with partial epilepsy with or without secondary generalization), who were resistant to optimized treatment with other drugs and who suffered at least four attacks per month. Lamotrigine was administered progressively, the final dose varying between 25 and 400 mg per day, the average being 192.3 mg. Lamotrigine was suspended in four cases (11%) as a result of behavioural abnormalities; three further patients showed slight secondary effects; no exanthemata were observed. The average age of the 32 patients who continued with treatment was 36.25 years and the average duration of epilepsy was 22.41 years. Average follow-up time was 26.9 weeks. In the case of two patients (5.55%) the attacks disappeared during follow-up time; 25 patients (69.4%) experienced at least a 50% objective reduction in the number of attacks. In no case was treatment suspended for lack of effect. Two patients gave up other drugs and continued monotherapy using Lamotrigine. In nine of the ten Lennox-Gastaut syndrome patients the frequency of attacks went down by more than 50% and in seven such cases by more than 75%.