CLINICAL EXPERIENCE WITH LAMOTRIGINE FOR PARTIAL SEIZURES IN CHILDREN
Abstract number :
1.278
Submission category :
Year :
2003
Submission ID :
3668
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Mary R. Andriola, Lourdes Bello, Scott Pearlman Neurology Stony Brook University Epilepsy Management Program, State University of New York at Stony Brook, Stony Brook, NY
LAMOTRIGINE (LTG) is a broad-spectrum antiepileptic drug (AED) initially approved in the United States for adjunctive use in patients [ge]16 years old with partial epilepsy and for patients age 2 years or older with generalized seizures associated with Lennox-Gastaut syndrome. Approval was expanded this year to pediatric patients [ge]2 years with partial epilepsy with or without secondary generalization. The objective of this study was to evaluate our clinical experience with LTG in children with partial epilepsy in an academic referral center.
This retrospective chart analysis included 13 children who received LTG as adjunctive therapy for partial epilepsy from November 2001 to February 2003. LTG was slowly titrated up and given as follows:
LTG + Enzyme inducing AED without Valproate (VPA):0.6 mg/kg/day in 1 or 2 divided doses, increased up to maintenance doses of 5-10 mg/kg/day.
LTG + AED regimen with Valproate (VPA):0.15 mg/kg/day in 1 or 2 divided doses increased up to maintenance doses of 1-5 mg/kg/day.Patients were evaluated regarding efficacy and side effects.
The study included 9 boys and 4 girls, ranging in age from 2-14 years, mean age=8 years. Twelve patients were initially on 1 or 2 AEDs. One patient was started as monotherapy. The most common concurrent AEDs were Valproate=4, Carbamazepine=2 and Topiramate=2.
Nine patients (69%) had[ge] 50% seizure reduction with the addition of LTG. Four (31%) were able to achieve conversion to monotherapy.
Four (31%) remain seizure free after 14 months follow up.
Two patients discontinued the medication due to lack of efficacy. Two due to AEs.
No patients developed a rash.
Five patients (38 %) experienced side effects that included drowsiness (n=2), behavioral changes (n=1), nausea (n=1), anorexia (n=1) ataxia (n=1) and double vision (n=1).
LTG was safe, effective and well tolerated in our pediatric patients with partial epilepsy. It was useful as monotherapy with complete seizure control achieved in some patients. Helpful dosing and the new FDA approval should allow for greater use of LTG in this age group.