Abstracts

People with epilepsy (PWE) that are seizure-free report their subjective health status similar to that of the general population based on quality of life scores. However, depressive symptoms and side effects from some antiepileptic drugs (AEDs) can have a negative effect on quality of life, independent of seizure control. The 31-item Quality of Life Inventory in Epilepsy (QOLIE-31) is a validated questionnaire which measures epilepsy-specific items such as seizure worry and broader items such as emotional well being and social functioning. Higher scores indicate a better quality of life. The Adverse Events Profile (AEP) is a validated scale that screens for adverse events of AED therapy. A score [ge] 45 on the AEP has been reported to be associated with high levels of AED side effects. Lamotrigine is an AED that has been shown to improve mood, social interaction and overall wellbeing in PWE. This analysis evaluated the effects of LTG on the quality of life in PWE and comorbid depressive symptoms. This was a multicenter open-label study. Lamotrigine was added onto a stable AED regimen in the adjunctive phase and became a single agent in the monotherapy phase. Patients were eligible for the study if they had epilepsy, exhibited depressive symptoms [Center for Epidemiological Studies Depression Scale (CES-D) [ge] 12] but were excluded if they had a Major Depressive Disorder as determined by a Mini International Neuropsychiatric Interview (M.I.N.I.) evaluation. Quality of life was measured with the QOLIE-31 scale and the AEP. Evaluations were conducted at baseline, at the end of the adjunctive phase (Week 19) and the monotherapy phase (Week 36). Statistical analysis was done using paired t-tests. One hundred fifty-eight PWE (102 women, 56 men) enrolled into the study. A total of 96 patients completed the adjunctive phase and 66 completed the monotherapy phase. Mean baseline, end of adjunctive (week 19) and monotherapy (week 36) scores for the QOLIE-31 were 53.1, 64.8, and 72.3; AEP scores were 45.1 at baseline, 41.2 at the end of adjunctive and 37.1 at the end of monotherapy. Change scores for the QOLIE-31 were 11.0 at the end of adjunctive and 18.9 at the end of monotherapy; for the AEP, change scores were -4.6 and -9.8 during the same period. All change scores were significant at p [lt]0.0001. Seizure[ndash]free rates were 36% at baseline, 56% after adjunctive therapy and 67% after monotherapy. This evaluation suggests that comorbid depressive symptoms, AED therapy, or both, may have a negative impact on the subjective health status in PWE. The addition of LTG to the AED regimen in PWE significantly improved QOLIE-31 and AEP scores suggesting improved quality of life. (Supported by GlaxoSmithKline Research and Development.)