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Lamotrigine has been licensed widely as adjunctive therapy for partial and secondary generalised seizures.Use of the drug as monotherapy was investigated in a double-blind,randomised,parallel-group comparison with carbamazepine in newly diagnosed epilepsy.After 4 weeks of planned,fixed dose escalation,doses were adjusted according to efficacy,adverse events, and plasma concentrations.151 of 260 patients(131 lamotrigine,129 carbamazepine)in eight UK centres completed the 48-week trial.No differences in efficacy between the drugs were found for partial seizures with or without secondary generalisation or for primary generalised tonic- clonic seizures.The proportion of patients maintained seizure-free during the last 24 weeks of treatment was almost the same in both groups(39% lamotrigine,38%carbamazepine).More patients with primary generalised tonic-clonic seizures(47%both groups)than those presenting with a focal onset(35%,37%)were fully controlled.Overall,fewer patients on lamotrigine than on carbamazepine withdrew because of adverse events(15 vs 27%).The commonest side-effect leading to withdrawal with either drug was rash(9%, 13%).Sleepiness was less common in lamotrigine than in carbamazepine recipients(12 vs 22%,p<0.05).More lamotrigine than carbamazepine recipients(65 vs 51%,p=0.018)completed the study(hazard ratio 1.57[95%CI 1.07-2.31].Lamotrigine and carbamazepine showed similar efficacy against partial onset seizures and primary generalised tonic-clonic seizures in newly diagnosed epilepsy.Lamotrigine,however,was better tolerated. |
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anticonvulsants
carbamazepine
lamotrigine
seizure
seizure,treatment of
seizure,treatment of,monotherapy
treatment of neurologic disorder
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