Lamotrigine Adjunctive Therapy Among Children and Adolescents With Primary Generalized Tonic-Clonic Seizures

Trevathan, Edwin; Kerls, Susan; Hammer, Anne E.; Vuong, Alain; Messenheimer, John A.

doi:10.1542/peds.2006-0148

Cited by 39 publications

(48 citation statements)

References 29 publications

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“…Brodie et al 12 reported that those patients with idiopatic GTC seizures had a better response to treament than those with partial seizures (with or without secondary generalization). Trevathan et al 16 reported the same good control of primary tonic-clonic generalized seizure, in a subgroup of 14 children age 2 to 20 years old of a randomized clinical trial, but they were also on 1 or 2 concurrent anti epileptic drugs (AEds). In our study we also noticed that patients with generalized tonic clonic seizures had a more satisfactory control.…”

Section: Resultsmentioning

confidence: 96%

Association of lamotrigine and valproate in refractory epilepsies of children and adolescents

Karen

Bruck

Antoniuk

et al. 2008

Arq. Neuro-Psiquiatr.

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-Objective: To evaluate the efficacy or eventual side-effects of the association of lamotrigine and sodium valproate in the control of refractory epilepsies. Method: A retrospective analysis of 37 children with a mean age of 12 years taking exclusivelly lamotrigine and sodium valproate. Efficacy of seizure control was considered satisfactory if there was a reduction in seizures ≥50% or total control. Results: The association of lamotrigine and sodium valproate was considered satisfactory in 65% of the studied children, independent of seizure type. Total seizure control was obtained in 33% and 35% had an unsatisfactory response or remained unchanged. Primary generalized tonic clonic seizures were the most common type with 84% of day-time seizures having a good response to treatment. Side-effects were seen in 11% of patients and the most common was tremor. Conclusion: Total or satisfactory control of seizures was seen in the majority of patients and sideeffects were uncommon.KEy wordS: epilepsy, refractory, valproate, lamotrigine, childhood. Associação de lamotrigina e valproato de sódio no tratamento de epilepsia refratária em crianças e adolescentesResumo -Objetivo: Avaliar a eficácia ou eventuais efeitos colaterais da associação de lamotrigina e valproato de sódio no controle de epilepsia refrataria. Método: Análise retrospectiva de 37 crianças e adolescentes com idade média de 12 anos tratadas exclusivamente com lamotrigina e valproato de sódio. A eficácia do controle de crises foi considerada satisfatória se o controle das crises foi ≥50% ou total. Resultados: A associação de lamotrigina e valproato de sódio foi considerada satisfatória em 65%, independente do tipo de crise. o controle total de crises foi obtido em 33% e em 35% a resposta foi insatisfatória ou permaneceu inalterada. Crise generalizada primaria tônico clonica foi o mais comum, com 84% das crises ocorrendo durante o dia, com boa resposta ao tratamento. Efeitos colaterais foram vistos em 11% dos pacientes, sendo tremor o mais freqüente. Conclusão: Controle total ou satisfatório das crises ocorreu na maioria dos pacientes, sendo pouco freqüente os efeitos colaterais.

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Section: Resultsmentioning

confidence: 96%

Association of lamotrigine and valproate in refractory epilepsies of children and adolescents

Karen

Bruck

Antoniuk

et al. 2008

Arq. Neuro-Psiquiatr.

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“…Its main disadvantage is the slow titration rate needed to avoid skin rashes; the titration must be even slower if LTG is used with valproate. 27 Lamotrigine was first synthesized in the 1970s based on the observations that many existing AEDs were folic acid antagonists 28 ; however, LTG has very little folic acid antagonism. Although the precise mechanism of action of LTG is unknown, a proposed mechanism is a use-dependent blocking effect on voltage-sensitive sodium channels.…”

Section: Discussionmentioning

confidence: 99%

Generalized Myoclonus and Spasticity Induced by Lamotrigine Toxicity

Algahtani¹,

Aldarmahi²,

Al-Rabia³

et al. 2014

Clinical Neuropharmacology

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Lamotrigine (LTG) is a well-tolerated broad-spectrum antiepileptic drug, which is chemically unrelated to other existing antiepileptic medications. The drug has also some mood-stabilizing properties and, according to some studies, modest antidepressant effects. The exact mechanism of action is unknown, but some animal studies suggest the inhibition of neuronal glutamate release. Despite being relatively safe, LTG has been demonstrated to have proconvulsant effect especially in certain types of epilepsies like myoclonic status epilepticus. Myoclonic status epilepticus and its variations including generalized myoclonic status epilepticus, status myoclonus, and prolonged myoclonus describe a variety of clinical states, which have continuous, unremitting seizures lasting longer than 5 minutes. It is not a commonly reported treatment-emergent neurological complication, but the treatment is always a medical emergency. We report a case of a 46-year-old man who developed generalized myoclonus status epilepticus a few hours after suicidal ingestion of LTG. He remained hemodynamically stable throughout hospitalization and started to recover and achieved complete recovery 3 days later. This is the first reported case of this de novo complication induced by LTG toxicity. We proposed a subcortical mechanism for this complication induced by the toxic doses of LTG.

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“…Two good examples in developmental psychopharmacology would be drugs such as clozapine and lamotrigine. The use of these two drugs is much less controversial because they have been shown to be efficacious for conditions such as treatmentrefractory schizophrenia and epilepsy in paediatric patients (Sporn et al, 2007;Trevathan et al, 2006).…”

Section: Efficacymentioning

confidence: 99%

“…We should take advantage of the new regulatory agency laws (FDA Pediatric Research Equity Act of 2003and EMA regulations 1901/2006and 1902/2006) that are creating huge data sets of clinical and treatment data from the large numbers of clinical trials that are being conducted (Stoyanova-Beninska et al, 2011). For instance the new EU paediatric regulation forces the drug industry to conduct clinical trials with paediatric populations before a licence is granted for adult populations.…”

Section: The Future Of Developmental Neuropsychopharmacologymentioning

confidence: 99%

Present and future of developmental neuropsychopharmacology

Arango

2015

European Neuropsychopharmacology

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Lamotrigine Adjunctive Therapy Among Children and Adolescents With Primary Generalized Tonic-Clonic Seizures

Abstract: Adjunctive lamotrigine therapy seems effective in controlling primary generalized tonic-clonic seizures among patients 2 to 20 years of age.

Cited by 39 publications

References 29 publications

Association of lamotrigine and valproate in refractory epilepsies of children and adolescents

Association of lamotrigine and valproate in refractory epilepsies of children and adolescents

Generalized Myoclonus and Spasticity Induced by Lamotrigine Toxicity

Present and future of developmental neuropsychopharmacology

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