Abstracts

To compare the efficacy and safety of add-on treatment of levetiracetam (LEV) and lamotrigine (LTG) in late onset epilepsy. LEV or LTG were randomly assigned (1:1) to 40 elderly patients with epilepsy previously clinically uncontrolled on antiepileptic drug (AED) monotherapy regimens. Patients were assessed for a 12 month follow-up period, using individual diaries (for efficacy) and Ward scale for side-effects; EEGs, routine bloods and neuropsychological tasks were also evaluated. Interim data are presented here. To date, 14 of 40 patients aged 65-85 (mean 73.1) years have completed 12 months follow-up. At 3 months : 5/20 (25%) LEV-treated (daily dose 1000 to 3000 mg) patients were seizure-free compared to 1/20 (5%) treated with LTG (daily dose 150 to 500 mg). Seizure reduction [ge]50% was seen in 14/20 (70%) patients receiving LEV and 4/20 (20%) patients receiving LTG. After 6 months the percentage seizure-free was unchanged for LEV, 2 LTG-treated patients became seizure-free, the percentage of patients with [ge]50% seizure reduction remained unchanged for both treatments. 2 patients prematurely discontinued LEV (due to side effects) and 5 discontinued LTG (2 for lack of efficacy, 3 for side effects). No significant changes in clinical, haematological or neuropsychological profiles were observed. Our results suggest that the efficacy and safety of add-on LEV in elderly patients may be in some instances superior to those observed for LTG. LEV could have substantial potential use in the elderly due to its efficacy, safety, easy and fast titration programme and lack of drug interactions.