Abstracts

RATIONALE: Epilepsy and behavioral disorders are frequent comorbid conditions in persons with mental retardation (MR). In a trial evaluating the efficacy of lamotrigine (LTG) in persons with epilepsy and MR (Neurology 2000;54,7,Suppl 3:A192), behavioral assessments (Aberrant Behavior Checklist, ABC; Habilitative Improvement Scale, HIS) were used to address this issue.
METHODS: Persons ([gte]12 yrs) taking 1-3 AEDS but still having seizures, entered an 8-week Baseline with doses of concurrent AEDs kept constant. LTG (LAMICTAL[reg]) was titrated over the next 8 weeks, then during an 8-week Maintenance, doses of AEDs were held constant. During the next 12 weeks of Optimization, the number/doses of AEDs were adjusted as needed for optimal response. Outcome measurements were changes from Baseline to week-36.
RESULTS: For the adolescent subgroup ([gte]12 and [lte]20 years), n=22, 50% female, with mean age=17 years. Level of MR was 18% mild, 18% moderate, 23% severe, 41% profound. Patients were in private families (68%), institutions (27%), group homes (5%). Most common seizures types were complex partial (36%), partial with secondarily generalization (23%), primary generalized (45% tonic-clonic, 23% myoclonic, 18% absence). The mean LTG dose during Optimization was 193 mg/day with VPA, 375 mg/day without VPA. Of all adolescent patients, 15% became seizure free, 40% experienced a 75% decrease in seizures. Mean HIS score improvement (8.7 to 16.2) was significant (p[lt]0.01). All 5 ABC dimensions showed improvement, with mean scores improving significantly (p[lt]0.05) for Lethargy (7.7 to 3.7), for Hyperactivity (6.8 to 4.5), and stereotypic behavior (2.7 to 1.7).
CONCLUSIONS: LTG decreased both seizure frequency and maladaptive behavior, improving social behavior and habilitation potential in adolescents with epilepsy and MR.
[Supported by: GlaxoSmithKline]; (Disclosure: Salary - Vuong, Hammer, Messenheimer, Grant - McKee, Messenheimer, Stock - Vuong, Messenheimer)