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Lamotrigene Does Not Always Exacerbate Seizures, Study Finds: Presented at AES
By Bonnie Darves
BOSTON, MA -- December 16, 2003 -- Concern about worsening of myoclonic seizures among paediatric patients taking the antiepileptic drug lamotrigene may be overstated. The drug has proved effective for many patients with juvenile myoclonic epilepsy (JME), researchers reported here December 9th at the American Epilepsy Society Annual Meeting.
"There has been a lot of concern about lamotrigene worsening myoclonic seizures, and we wanted to see if that was true," said Jesus Martinez, MD, lead author of a new study, and member of the Comprehensive Epilepsy Program, University of Virginia, Charlottesville, United States. "The bottom line is that you may have some [seizure] exacerbation when you're titrating up, but we don't think that lamotrigene worsens it overall."
In a retrospective study of patients with JME (mean onset age of 17.9 years), 22 were taking lamotrigene and 43 were taking other antiepileptic drug. Researchers analysed frequency and characteristics of myoclonic, generalized tonic clonic (GTC) and absence seizures prior to start of LMT therapy. At baseline, 11 patients had a history of GTC seizures, 11 had myoclonic seizures and 2 had absence seizures.
After 12 months of treatment, all GTC patients had achieved full seizure control, and 6 of the myoclonic-group patients were seizure-free. Two patients did experience myoclonic exacerbation during the first 3 months of LMT therapy, but that largely subsided after titration to optimal dose had occurred, Dr. Martinez said. One patient discontinued LMT treatment at 9 months because of seizure exacerbation.
"What we think is that those [myoclonic] seizure exacerbations may be transient in nature, which would explain the disparity -- why some studies have found more exacerbations and other have found less frequent exacerbations," he said. "We also think that compliance [with medication taking] may be an issue [that contributes to seizure exacerbation]."
[Study Title: Frequency of Myoclonic Seizure Exacerbation by Lamotrigine in JME. Abstract 2268]
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