Abstracts

RATIONALE: Studies of the efficacy of lamotrigine (LTG) in the treatment of epileptic seizures typically are conducted under rather artificial experimental conditions. Although such studies demonstrate the worth of LTG in the treatment of seizures, much less is known about the efficacy and tolerability of LTG in a clinical setting. To address these questions we conducted a prospective, observational study of outpatients receiving LTG, emphasizing both positive and negative mood and quality of life (QOL) changes. Our objective was to assist the clinician in making anti-epileptic medication choices with this data.
METHODS: We recruited subjects treated at the outpatient centers of the Long Island Jewish Comprehensive Epilepsy Center who were identified as appropriate candidates for LTG treatment by their epileptologists. Patients 18 years of age or older with IQ greater than or equal to 70 were included. Patients completed the Quality of Life in Epilepsy-31 inventory (QOLIE-31), the Profile of Mood States survey (POMS), and a seizure severity scale at baseline, 2 months, 6 months, and 1 year after beginning LTG, with the dosage titrated according to concomitant anti-epileptic medications.
RESULTS: Out of 24 patients enrolled to date, nine have completed the baseline evaluation and 2 month assessment after LTG initiation. In this two month interval, before attaining maximal LTG dosage, four patients improved (three with [gt]50% decrease in seizure frequency), two remained unchanged and seizure free, two remained unchanged with continued seizures, and one had an increase in seizures. There was significant improvement (p[lt]0.033) in the QOLIE-31 Overall Score, with significant improvement (p[lt]0.05) on subtests assessing seizure worry, emotional well-being, and cognitive functioning. The POMS showed significant improvement (p[lt]0.05) in vigor and fatigue, with all patients reporting less fatigue, and 8/9 patients reported increased vigor.
CONCLUSIONS: These preliminary data indicate positive mood and quality of life effects following initiation of LTG. Although the sample size in this initial report is small, the data suggest improved seizure control after only 2 months of treatment and behavioral improvement in several domains. Results of this study will provide information on improvement in both efficacy and quality of life that will assist the clinician in choosing among the abundance of new anti-epileptic medications.
[Supported by: GlaxoSmithKline]; (Disclosure: Grant - Glaxo Smith Kline)