Treatment of epilepsy in adults: expert opinion, 2005

Karceski, Steven; Morrell, Martha J.; Carpenter, Daniel

doi:10.1016/j.yebeh.2005.06.001

Cited by 176 publications

(134 citation statements)

References 49 publications

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“…In the last 15 years, the advent of new generation AEDs has provided attractive options for the management of seizure disorders in the elderly because some of these drugs have a favorable tolerability profile and a lower potential to interact with other drugs and aggravate comorbidities (Willmore, 2000;Alvarez-Sabin et al, 2002;Tomson, 2004;Karceski et al, 2005). Among newer AEDs, LTG has been the most extensively investigated in older patients, and is often regarded as the treatment of choice for the majority of such patients (Willmore, 2000;Karceski et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

An International Multicenter Randomized Double‐Blind Controlled Trial of Lamotrigine and Sustained‐Release Carbamazepine in the Treatment of Newly Diagnosed Epilepsy in the Elderly

et al. 2007

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Summary:Purpose: To assess the comparative effectiveness, efficacy, and tolerability of lamotrigine (LTG) and sustainedrelease carbamazepine (CBZ) in the treatment of newly diagnosed epilepsy in the elderly.Methods: Patients aged 65 years or older, who had experienced at least two unprovoked partial and/or generalized tonicclonic seizures, were randomized to receive LTG (n = 93) or CBZ (n = 92) according to a multicenter double-blind, parallelgroup design. Trial duration was 40 weeks and included a 4-week dose escalation followed by a maintenance phase during which dosages could be adjusted according to response. Initial, maintenance and maximum dosages were 25 mg, 100 mg, and 500 mg per day for LTG, and 100 mg, 400 mg, and 2,000 mg per day for CBZ, respectively. The primary end point was retention in the trial. Results:In the LTG group, 68 patients (73%) completed the 40-week study period compared with 61 (67%) in the CBZ group, a nonsignificant difference. Time to withdrawal from any cause did not differ between groups (p = 0.34). The number of subjects who completed the 40-week period and were seizure free in the last 20 weeks was 48 (52%) in the LTG group and 52 (57%) in the CBZ group. Adverse events leading to withdrawal occurred in 13 (14%) subjects in the LTG group and 23 (25%) subjects in the CBZ group.Conclusion: LTG and CBZ showed comparable effectiveness, with a trend for higher seizure-free rates for CBZ and better tolerability for LTG. Differences in outcome compared with previous trials may be related to different dosing rates and use of a sustained-release formulation for CBZ.

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Section: Discussionmentioning

confidence: 99%

An International Multicenter Randomized Double‐Blind Controlled Trial of Lamotrigine and Sustained‐Release Carbamazepine in the Treatment of Newly Diagnosed Epilepsy in the Elderly

et al. 2007

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“…For the treatment of epilepsy, monotherapy is preferred to polytherapy, since it decreases potential drug-drug interactions and reduces adverse events [1]. The UK National Institute for Health and Clinical Excellence (NICE) guideline recommends epilepsy patients be treated with monotherapy wherever possible [2].The Standard and New Antiepileptic Drugs (SANAD) studies have been reported in the UK.…”

Section: Introductionmentioning

confidence: 99%

“…Various guidelines [1,2,8] recommend lamotrigine as a first-line treatment for partial and generalized seizures. However the use of lamotrigine monotherapy has not yet been established in Japan.…”

Section: Introductionmentioning

confidence: 99%

Lamotrigine monotherapy in newly diagnosed epilepsy or recurrent epilepsy:A multi-center, open-label study

Yamamoto

Hong

Shimizu

et al. 2014

E&S

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Purpose:To evaluate the efficacy and safety of lamotrigine monotherapy in patients with newly diagnosed partial seizures including secondarily generalized seizures or generalized tonic-clonic seizures, and those with recurrent seizures in Japan and South Korea. Methods: The study was a multi-center, open-label, evaluation of lamotrigine monotherapy in patients with newly diagnosed epilepsy or epilepsy with recurrent seizures. The primary endpoint was the seizure-free rate in the maintenance phase. Results: A total of 67 patients were enrolled; 52 patients completed 6 weeks of treatment (the escalation phase) and 42 patients completed 30 weeks of treatment (the escalation phase and the maintenance phase). The seizure-free rate in the maintenance phase for all seizure types was 43.1%. Adverse events (AEs) were reported in 82% (53/65) of patients. The most common AEs were headache (14/65, 22%), nasopharyngitis (12/65, 18%) and rash (7/65, 11%). Conclusion:The seizure-free rate with lamotrigine monotherapy in the maintenance phase was 43.1% for all seizure types. Lamotrigine monotherapy appears to be effective in patients with newly diagnosed epilepsy and those with recurrent seizures in Japan and South Korea. The safety profile of lamotrigine in this monotherapy study was similar to that observed in patients with adult bipolar disorder treated with lamotrigine monotherapy.

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“…Необходимо учитывать негативные косметиче-ские эффекты ПЭП, риск гормональных и эндокринных нарушений (ФБ, фенитоин, вальпроаты). Предпочти-тельны ПЭП нового поколения [13, [15][16][17][18].…”

Section: эпилепсия и пубертатный периодunclassified