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Elderly Patients With Epilepsy Appear To Respond Well To Lamotrigine
A DGReview of :"The Tolerability of Lamotrigine in Elderly Patients With Epilepsy"
Drugs & Aging
08/31/2001
By Veronica Rose
Lamotrigine is well tolerated by elderly patients with epilepsy, providing it is used according to the currently prescribed adult dosage, say researchers.
Investigators at Glaxo Wellcome laboratories in Greenford, England and North Carolina, United States designed a study to determine the tolerability of lamotrigine in elderly patients suffering with epilepsy. They used data pooled from 13 clinical trials.
Two hundred and eight elderly patients aged -/> 65 years participated in the trials undertaken in primary care and neurology practices. They comprised 146 patients who were prescribed lamotrigine, 53 patients were treated with carbamezapine and nine were given phenytoin. Researchers examined the extent of exposure, drug-related adverse events incidence, severe events and withdrawal from the study.
The patients received lamotrigine monotherapy and add-on therapy for a median duration of 24.1 and 47.4 weeks respectively. The median daily dose of lamotrigine was 100 mg for monotherapy (range 75- 500mg) and 300 mg for add-on therapy (range 25-700mg).
There was a lower overall incidence of drug-related adverse effects for lamotrigine than comparator medication. This included 49 percent for lamotrigine (72/146) by comparison with 72 percent (38/53) for carbamazepine, and 89 percent (8/9) for phenytoin. However, patient numbers in each group were not comparable.
Patients prescribed lamotrigine reported incidences of drowsiness, rash and nonsignificant headache that was a half of those experienced by patients who received carbamezapine monotherapy. The most frequent cause for withdrawal was a rash. This was experienced by 4 percent of patients prescribed lamotrigine (6/146), and 17 percent (9/53) of those treated with carbamezapine.
There were no incidences of withdrawal due to a rash among patients taking phenytoin. Seven of the patients prescribed lamotrigine (5 percent, 7/146) four of those treated with carbamezapine (8 percent, 4/53) and one given phenytoin (11 percent, 1/9) experienced serious drug-related adverse effects.
Drugs and Aging 2001 Vol 18 No 8 pp 621-630.
"The Tolerability of Lamotrigine in Elderly Patients With Epilepsy"
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