Double-blind comparison of lamotrigine and carbamazepine in newly diagnosed epilepsy

Lamotrigine has been licensed widely as adjunctive therapy for partial and secondary generalised seizures. Use of the drug as monotherapy was investigated in a double-blind, randomised, parallel-group comparison with carbamazepine in newly diagnosed epilepsy. After 4 weeks of planned, fixed dose esc...

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Bibliographic Details
Published in:The Lancet (British edition) 1995-02, Vol.345 (8948), p.476-479
Main Authors: Brodie, M.J., Richens, A., Yuen, AWC, UK Lamotrigine/Carbamazepine Monotherapy Trial Group
Format: Article
Language:English
Subjects:
Anticonvulsants. Antiepileptics. Antiparkinson agents
Biological and medical sciences
Drug therapy
Epilepsy
Medical research
Medical sciences
Neuropharmacology
Pharmacology. Drug treatments
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Summary:Lamotrigine has been licensed widely as adjunctive therapy for partial and secondary generalised seizures. Use of the drug as monotherapy was investigated in a double-blind, randomised, parallel-group comparison with carbamazepine in newly diagnosed epilepsy. After 4 weeks of planned, fixed dose escalation, doses were adjusted according to efficacy, adverse events, and plasma concentrations. 151 of 260 patients (131 lamotrigine, 129 carbamazepine) in eight UK centres completed the 48-week trial. No differences in efficacy between the drugs were found for partial seizures with or without secondary generalisation or for primary generalised tonic-clonic seizures. The proportion of patients maintained seizure-free during the last 24 weeks of treatment was almost the same in both groups (39% lamotrigine, 38% carbamazepine). More patients with primary generalised tonic-clonic seizures (47% both groups) than those presenting with a focal onset (35%, 37%) were fully controlled. Overall, fewer patients on lamotrigine than on carbamazepine withdrew because of adverse events (15 vs 27%). The commonest side-effect leading to withdrawal with either drug was rash (9%, 13%). Sleepiness was less common in lamotrigine than in carbamazepine recipients (12 vs 22%, p
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(95)90581-2