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Gabapentin, Lamotrigine Equally Effective And Tolerated For Newly Diagnosed Epilepsy
A DGReview of :"Gabapentin versus lamotrigine monotherapy: a double-blind comparison in newly diagnosed epilepsy"
Epilepsia
10/18/2002
By Alison Palkhivala
Gabapentin and lamotrigine appear to have similar efficacy and tolerability profiles for the treatment of epilepsy in newly diagnosed patients.
M. J. Brodie and colleagues from the Epilepsy Unit, University Department of Medicine and Therapeutics, Western Infirmary, Glasgow, Scotland, compared gabapentin and lamotrigine as monotherapy for the treatment of 309 patients who were newly diagnosed with epilepsy. Patients included in this double-blind study experienced partial seizures with or without secondary generalization or had primary generalized tonic-clonic seizures.
The investigators randomly assigned patients to treatment with gabapentin 1,800 mg/day or lamotrigine 150 mg/day. Both agents were titrated up slowly; the titration period was two weeks for gabapentin and six weeks for lamotrigine. After initial titration, patients remained on their drug for a 24-week maintenance phase during which time additional dose adjustments could be made based on seizure control and side effects. Gabapentin patients were maintained on 1,200 to 3,600 mg/day, and lamotrigine patients were maintained on 100 to 300 mg/day.
Among the original 309 patients, the investigators included 291 in the final efficacy analysis. The median time to therapy cessation was 69 days among those taking gabapentin and 48 days for those taking lamotrigine. One hundred and six patients taking gabapentin completed the study and 80 (76 percent) remained seizure-free during the final 12 weeks of treatment. In comparison, 96 of the lamotrigine-treated patients completed the study, and 73 (76 percent) remained seizure-free for the final 12 weeks. Only 14 of the gabapentin-treated patients and 15 of the lamotrigine-treated patients stopped taking the study medication because of adverse events related to the drugs.
According to the authors, gabapentin and lamotrigine monotherapy are comparable in their efficacy and tolerability for the treatment of patients with newly diagnosed epilepsy.
Epilepsia 2002 Sep;43(9):993-1000.
"Gabapentin versus lamotrigine monotherapy: a double-blind comparison in newly diagnosed epilepsy"
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