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Efficacy and safety of lamotrigine monotherapy in children and adolescents with epilepsy
Journal article   Peer reviewed

Efficacy and safety of lamotrigine monotherapy in children and adolescents with epilepsy

Ignacio Valencia, Gerard Pinol-Ripoll, Divya S. Khurana, Huntley H. Hardison, Sanjeev V. Kothare, Joseph J. Meluin, Harold G. Marks and Agustin Legido
European journal of paediatric neurology, v 13(2)
01 Mar 2009
DOI: https://doi.org/10.1016/j.ejpn.2008.03.002
PMID: 18585941
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Clinical Neurology Life Sciences & Biomedicine Neurosciences & Neurology Pediatrics Science & Technology
Lamotrigine (LTG) has shown to confer broad-spectrum, well-tolerated control of epilepsy. Monotherapy is preferable over polytherapy because of better compliance, fewer adverse events, less interactions, lower teratogenicity and lower cost. The aim of this study is to evaluate the efficacy and safety of LTG monotherapy on seizure control in a cohort of children and adolescents with epilepsy. We retrospectively reviewed the records of children and adolescents treated with LTG monotherapy at our institution between 2001 and 2006. Data collected included demographics, seizure type, etiology of seizures, age at onset of seizures and at initiation of LTG treatment, number of antiepileptic drugs (AEDs) prior to LTG, dose of LTG, length of follow-up, treatment response, and adverse events. Seventy-two children and adolescents were identified (mean age 12.1 years); 37.5% had mental retardation. Age at onset of epilepsy was 5.7 years (0-16). Twenty three percent had symptomatic focal epilepsy, 15.5% idiopathic focal epilepsy, 19.4% symptomatic generalized epilepsy and 41.6% idiopathic generalized epilepsy. LTG was used as first-line monotherapy in 26.4% of patients and as a second-line monotherapy in 73.6%. Age at initiation of LTG therapy was 10 years (2.8-19). Mean number of AEDs tried prior to LTG was 1.3 (0-6). Mean dose of LTG was 5.5 mg/kg/day (1.1-13.7). Mean follow-up period was 33 months (3 weeks to 11.5 years). The degree of seizure reduction was as follows: seizure free in 42%, 75-90% reduction in 17.4%, 50-74% in 11.6%, 25-49% in 10%. Sixteen percent had no change in seizure control and 3% became worse. The most common adverse event was rash (6.9%). Six (8.3%) patients discontinued LTG because of the adverse events. No patient had Stevens-Johnson syndrome. In conclusion, LTG was effective and well-tolerated as monotherapy in children and adolescents for both focal and generalized epilepsies. (C) 2008 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

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Web of Science research areas
Clinical Neurology
Pediatrics
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