Abstracts

We undertook a randomised, open-label study to compare the efficacy, tolerability, and androgenic effects of lamotrigine (LTG) and sodium valproate (VPA) monotherapy in newly diagnosed epilepsy., A total of 226 patients with a recent diagnosis of epilepsy were randomised (on an equal basis) to receive either LTG or VPA. Median age at recruitment was 35 years (range = 13 to 80 years). Sixty patients presented with idiopathic generalised epilepsy, 149 patients had localisation-related epilepsy, and 17 remained unclassified. Subjects were followed up at six-weekly intervals until reaching one of the study end points (1 year seizure freedom, withdrawal due to side effects, or withdrawal due to lack of efficacy). In addition, basic androgenic function was assessed by longitudinal analysis of serum testosterone and androstenedione concentrations., A total of 197 patients reached an end point. Median dose of VPA was 1000 mg/day (range 600 [ndash] 3000 mg/day), while the median dose of LTG was 200 mg/day (range 100 [ndash] 700 mg/day). Seizure freedom rates were similar for both drugs (67% and 60% for VPA- and LTG-treated patients, respectively). Withdrawal due to side effects was required in 24 VPA patients and 14 LTG patients. Similar numbers were withdrawn due to lack of efficacy (18 VPA, 15 LTG). Longitudinal assessment of androgenic function showed no significant change in either treatment arm., No significant differences were noted in measures of outcome (efficacy or tolerability) in groups of patients with newly diagnosed epilepsy treated with either VPA or LTG. Androgenic function was not affected by either treatment., (Supported by: This study was partly supported by an unrestricted educational grant from Sanofi.)