D. Battino et al., LAMOTRIGINE PLASMA-CONCENTRATIONS IN CHILDREN AND ADULTS - INFLUENCE OF AGE AND ASSOCIATED THERAPY, Therapeutic drug monitoring, 19(6), 1997, pp. 620-627
The effects of age and concomitant treatment on plasma lamotrigine (LT
G) concentration/dose (C/D) ratios were retrospectively evaluated on 4
82 consecutive routine LTG determinations from 106 chronically-treated
patients with epilepsy (40 children and adolescents aged younger than
16 years, and 66 adults aged 17 to 62 years), A linear dose/level rel
ationship was observed in individual patients but not in the cumulativ
e analysis, which failed to show any correlation between the administe
red LTG dose and plasma concentrations. In the adult group, there were
no correlations between the administered LTG dose and plasma concentr
ations. Associated antiepileptic therapy affected the LTG concentratio
n/dose ratio, which was significantly higher in the patients receiving
valproic acid (3.4 +/- 2.0, n = 23) and significantly lower in those
treated with enzyme-inducing antiepileptic drugs (0.6 +/-: 0.5, n = 57
) than in the patients receiving valproic acid in combination with enz
yme-inducing antiepileptic drugs? ethosuximide, vigabatrin, or clobaza
m (1.9 +/- 1.6, n = 26). The LTG CID ratios significantly increased wi
th increasing plasma valproic acid concentrations, and significantly d
ecreased with increasing phenytoin concentrations. The effect of enzym
e-inducing antiepileptic drugs increased with the number of associated
drugs. A clear age effect was demonstrated in the homogeneously treat
ed subgroups, in all of which adults had higher C/D ratios than childr
en.