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Antiepileptic, Valproate, Associated With Weight Gain
A DGReview of :"Weight change associated with valproate and lamotrigine monotherapy in patients with epilepsy"
Neurology
02/07/2001
By James Adams
Epilepsy patients treated with valproate show significantly higher weight gain within ten weeks of starting therapy compared to patients receiving lamotrigine, researchers find.
Weight change was the primary outcome measure of the study, but the researchers also report that efficacy of the two drugs is similar, and lamotrigine tended to be better tolerated.
The randomized, double-blind study was conducted by investigators from the Arkansas Epilepsy Program in Little Rock, Arkansas; the Comprehensive Epilepsy Care Center in St. Louis, Missouri; and Glaxo Wellcome at Research Triangle Park in North Carolina.
Drugs were administered with an eight-week escalation phase and a 24-week maintenance phase. Target dose was 200 mg/day for lamotrigine and 20 mg/kg/day for valproate, with some adjustments made at the discretion of the investigators.
Patients had new-onset or previously diagnosed partial or generalized seizures. All were 12 years of age or older. Sixty-five patients received lamotrigine and 68 received valproate. The lamotrigine group had a mean age of 34.5 years and mean age of the valproate group was 30.1 years.
Results showed a significantly higher weight gain of 5.81 ± 4.22 kg (12.8 ± 9.3 lbs) in the valproate group compared with 0.59 kg ± 5.40 kg (1.3 ± 11.9 lbs) in the lamotrigine group. The gains occurred by the 10th week of treatment and weight gain continued throughout the study.
Efficacy was similar in both drug groups, with 29 percent of patients in the lamotrigine group and 26 percent in the valproate group being seizure-free.
Adverse events led to a mean time of withdrawal from the study of 103 ± 70 days for the lamotrigine patients and 79 ± 48 days for the valproate patients, indicating a tendency towards better tolerance of lamotrigine.
Neurology 2001; 56: 172-177.
"Weight change associated with valproate and lamotrigine monotherapy in patients with epilepsy"
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