Authors' objectives:

The author investigates whether lamotrigine should be used as monotherapy for treating epilepsy in adults, in place of the established antiepileptic drugs, and whether it should be used as add-on therapy.

Authors' results and conclusions: LTG monotherapy appears to be as effective as established drugs in controlling partial and generalised seizures in the medium term. There is no data on long term reduction of seizure rate, or severity of seizure, or drug toxicity, resulting from LTG monotherapy. On the basis of time to withdrawal from participation, LTG seems to be better tolerated than established drugs: time to withdrawal suggests that for every 100 patients treated with LTG, an extra seven patients will continue therapy compared with CBZ.

Authors' recommendations: LTG may be a good option for patients with poorly controlled epilepsy due to treatment-limiting side effects, and those with a history of drug intolerance but adequate seizure control, but skin reactions are common and may be serious. The authors conclude that, as LTG as add-on therapy is significantly better than placebo at reducing frequency of seizures, they support its use. They offer only limited support for the use of LTG as monotherapy, as it is only as effective as established drugs in the medium term treatment of partial and generalised epilepsy in adults, but is more expensive. They add that, with no significant difference in efficacy, enhanced safety and tolerance are of critical importance in differentiating between alternative treatments, as is cost minimisation. LTG may be better tolerated than established drugs.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.wihrd.soton.ac.uk

Year Published: 1998

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: Wessex Institute for Health Research and Development

Contact Address: Pauline King. Wessex Institute for Health Research and Development, Boldrewood Medical School, Bassett Crescent East, Highfield, Southampton. SO16 7PX Tel. +44 1703 595661 Fax +44 1703 595662

Copyright: Wessex Institute for Health Research and Development (WIHRD)