LAMOTRIGINE ADJUNCTIVE THERAPY IN ADOLESCENTS WITH MENTAL RETARDATION AND REFRACTORY EPILEPSY: EFFECTS ON SEIZURE REDUCTION
Abstract number :
2.128
Submission category :
Year :
2002
Submission ID :
2589
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Theodore R. Sunder, Jerry R. McKee, Alain Vuong, Anne E. Hammer, John A. Messenheimer. Department of Neurology, Psychiatry and Pediatrics, Southern Illinois Medical School, Springfield, IL; Pharmacy Services, Western Carolina Center, Morganton, NC; Clinic
RATIONALE: Management of antiepileptic drugs (AED) in adolescents with mental retardation (MR) and epilepsy is difficult. These patients often have multiple seizure types and comorbid behavioral disorders. A focused analysis with adolescents was conducted from a larger study with lamotrigine (LTG) in patients with MR and epilepsy (Neurology 2000;54,7,Suppl 3:A192).
METHODS: Patients were [gte]12 years, had epilepsy with MR and were treated with 1-3 AEDs. Patients entered an 8-week Baseline with doses of concurrent AEDs kept constant. LTG (LAMICTAL[tm]) was titrated over the next 8 weeks, then during an 8-week Maintenance Phase doses of all AEDs were held constant. During the final 12 weeks, the Optimization Phase, the number and doses of AEDs were adjusted as needed for optimal therapeutic response.
RESULTS: For the adolescent subgroup ([gte]12 and [lte] 20 years), n=22, 50% female, with mean age 17 years [plusminus] 2. Level of MR was 18% mild, 18% moderate, 23% severe, 41% profound. Patients[ssquote] location was private families (68%), institutions (27%), group homes (5%). The most common seizures were complex partial (36%), partial with secondarily generalization (23%), primary generalized seizures (45% tonic-clonic, 23% myoclonic, 18% absence). The mean LTG dose during Maintenance was 154 mg/day [plusminus] 103 with VPA and 323 mg/day [plusminus] 51 without VPA. Of all adolescent patients, 25% became seizure free, 45% experienced a 75% decrease in seizures. 63% of investigators rated patients as having moderate or marked improvement in seizure frequency, duration and intensity. During Optimization, seizure reduction and investigators[ssquote] assessment were similar to the Maintenance Phase.
CONCLUSIONS: Therapy with LTG improved seizure frequency and overall status in adolescents with epilepsy and MR.
[Supported by: GlaxoSmithKline]