Add-on trial of lamotrigine followed by withdrawal of concomitant medication and stabilization on monotherapy

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Abstract

An open, multicentre, prospective trial of lamotrigine was carried out in adult patients with treatment-resistant epilepsy stabilized on monotherapy with phenytoin, carbamazepine or sodium valproate. The primary aim of the study was to assess the use of lamotrigine monotherapy following the withdrawal of concomitant medication in patients who were responsive to add-on lamotrigine. Of 347 patients recruited into the study, 338 entered the lamotrigine add-on phase, 142 (41%) attempted withdrawal of concomitant medication and 80 (23%) progressed to lamotrigine monotherapy. Sixty patients successfully completed all phases of the study. During the add-on phase, 47% of all patients had a reduction in seizure frequency of at least 50% compared with baseline. A significant proportion of patients could be successfully converted to lamotrigine monotherapy at daily dosages of 100-500 mg. Lamotrigine was also generally well tolerated. The most common treatment-emergent adverse events were dizziness (23% of cases) and diplopia (18%) in the carbamazepine group, dizziness and asthenia (10% each) in the phenytoin group, and rash (20%), dizziness, asthenia and headache (9% each) in the sodium valproate group. The rash rate could be reduced significantly by slow dose escalation, particularly in patients receiving sodium valproate (38% decreasing to 8% with slow dose escalation).

Original languageEnglish
Pages (from-to)23-29
Number of pages7
JournalInternational Congress and Symposium Series - Royal Society of Medicine
Issue number214
Publication statusPublished - 1996

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Valproic Acid
Dizziness
Asthenia
Carbamazepine
Phenytoin
Exanthema
Diplopia
lamotrigine
Multicenter Studies
Headache
Epilepsy
Seizures
Therapeutics

ASJC Scopus subject areas

  • Applied Microbiology and Biotechnology
  • Medicine(all)

Cite this

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title = "Add-on trial of lamotrigine followed by withdrawal of concomitant medication and stabilization on monotherapy",
abstract = "An open, multicentre, prospective trial of lamotrigine was carried out in adult patients with treatment-resistant epilepsy stabilized on monotherapy with phenytoin, carbamazepine or sodium valproate. The primary aim of the study was to assess the use of lamotrigine monotherapy following the withdrawal of concomitant medication in patients who were responsive to add-on lamotrigine. Of 347 patients recruited into the study, 338 entered the lamotrigine add-on phase, 142 (41{\%}) attempted withdrawal of concomitant medication and 80 (23{\%}) progressed to lamotrigine monotherapy. Sixty patients successfully completed all phases of the study. During the add-on phase, 47{\%} of all patients had a reduction in seizure frequency of at least 50{\%} compared with baseline. A significant proportion of patients could be successfully converted to lamotrigine monotherapy at daily dosages of 100-500 mg. Lamotrigine was also generally well tolerated. The most common treatment-emergent adverse events were dizziness (23{\%} of cases) and diplopia (18{\%}) in the carbamazepine group, dizziness and asthenia (10{\%} each) in the phenytoin group, and rash (20{\%}), dizziness, asthenia and headache (9{\%} each) in the sodium valproate group. The rash rate could be reduced significantly by slow dose escalation, particularly in patients receiving sodium valproate (38{\%} decreasing to 8{\%} with slow dose escalation).",
author = "E. Perucca",
year = "1996",
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journal = "International Congress and Symposium Series - Royal Society of Medicine",
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AB - An open, multicentre, prospective trial of lamotrigine was carried out in adult patients with treatment-resistant epilepsy stabilized on monotherapy with phenytoin, carbamazepine or sodium valproate. The primary aim of the study was to assess the use of lamotrigine monotherapy following the withdrawal of concomitant medication in patients who were responsive to add-on lamotrigine. Of 347 patients recruited into the study, 338 entered the lamotrigine add-on phase, 142 (41%) attempted withdrawal of concomitant medication and 80 (23%) progressed to lamotrigine monotherapy. Sixty patients successfully completed all phases of the study. During the add-on phase, 47% of all patients had a reduction in seizure frequency of at least 50% compared with baseline. A significant proportion of patients could be successfully converted to lamotrigine monotherapy at daily dosages of 100-500 mg. Lamotrigine was also generally well tolerated. The most common treatment-emergent adverse events were dizziness (23% of cases) and diplopia (18%) in the carbamazepine group, dizziness and asthenia (10% each) in the phenytoin group, and rash (20%), dizziness, asthenia and headache (9% each) in the sodium valproate group. The rash rate could be reduced significantly by slow dose escalation, particularly in patients receiving sodium valproate (38% decreasing to 8% with slow dose escalation).

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