Lamotrigine in childhood epilepsies

Lamotrigine (LTG) is one of the new generation of antiepileptic drugs (AEDs) that have been designed to perform specific physiological or pharmacological functions. Early laboratory testing revealed an AED profile auguring success in the management of generalized tonic-clonic seizures, partial seizures, and also absence, thus suggesting a broad spectrum of activity. The drug blocks voltage-sensitive sodium channels resulting in inhibition of excitatory neurotransmitter release. Randomized, controlled clinical trials confirmed effectiveness and the side effect profile was favorable. The use of LTG in childhood is based largely on anecdotal open-label derived information. To date it appears to have been successful in many of the most devastating childhood epilepsy syndromes but controlled trial information is needed to confirm that it may be not only successful as add-on in partial seizures but also in primary and secondarily generalized epilepsies as a primary agent.