The effect of lamotrigine on epilepsy

Epilepsy is a common neurologic disorder affecting about 1% of the population. 1 The prevalence of active epilepsy in Kerman is 7.87/1000. 2 In 23 countries of Asia the rate of epilepsy is the same as USA and Europe. Pharmacotherapy with antiepileptic drugs is the major treatment modality for epilepsy. This treatment could be a result of decreased excitation concurrent with increased inhibition. 3 The management of epilepsy differs from the treatment of other chronic diseases; a single breakthrough event has a major negative effect on the quality of life. The past decade has brought many advances to the treatment of epilepsy, including many new pharmacological agents. Lamotrigine is one of the new antiepileptic drugs, which has been used for more than two decades. Lamotrigine is effective in partial-onset and secondarily generalized tonic-clonic seizures, primary generalized seizures (i.e., absence seizures, and primary generalized tonic-clonic seizures), atypical absence seizures, tonic/atonic seizures, and Lennox-Gastaut syndrome. It is sometimes effective for myoclonic seizures, but it can worsen myoclonic seizures in some patients with juvenile myoclonic epilepsy or myoclonic epilepsy of infants. One of the main advantages of lamotrigine is that it causes less cognitive impairment or overt sedation compared with other treatments. 4 Its anti-aging effect on an animal model in a study has found that lamotrigine decreases mortality and increases lifespan. Lamotrigine has many side effects; the most important of which is allergic reactions. Introducing lamotrigine gradually is one of the keys to reducing the frequency and severity of allergic reactions. Although the incidence of cutaneous reactions to lamotrigine is high, the incidence of serious eruptions such as erythema multiform, Stevens-Johnson syndrome, and toxic epidermal necrolysis is low. 5 In this study we evaluated the effects of lamotrigine on epileptic patients. All epileptic patients who referred to our clinic were evaluated. We started with low dose (25-50 mg/day) lamotrigine and gradually increased dosage until the patients became seizure free or adverse events appeared. At first, we used lamotrigine once daily, but for patients who needed more than 150 mg/day we used twice a day. The patients had to be at least 6 months seizure free to be in the control group. For the patients experiencing side effects of the drug the treatment was discontinued. The patients who had other diseases rather than neurological disorders were omitted from the study. Before starting the drug, we did laboratory exams including white blood count, blood …