The long-term use of gabapentin, lamotrigine, and vigabatrin in patients with chronic epilepsy

Purpose: To compare the long-term retention of gabapentin (GBP), lamotrigin e (LTG), and vigabatrin (VGB) by patients with chronic epilepsy and the rea sons for treatment discontinuation. To assess the likelihood of seizure fre edom, seizure-related injury/hospital admission and mortality after these d rugs were commenced. Methods: This was a retrospective case-records survey in five tertiary refe rral epilepsy centres in the U.K. The retention times on treatment (from in itiation to discontinuation) for the different antiepileptic drugs (AEDs) w ere compared by using Kaplan-Meier survival analysis and Cox regression. In cidences of seizure freedom and seizure-related injury/hospital admissions and standardised mortality ratios were calculated. Results: There were 1,375 patients with chronic epilepsy included; 361 were taking GBP, 1,050 LTG, and 713 VGB. The retention of GBP, LTG, or VGB was <40% at 6 years. Fewer than 4% of patients become seizure free while taking one of the drugs. There was no reduction in mortality or seizure-related i njury/admission. Conclusions: The impact of these new AEDs on chronic epilepsy can be descri bed only as modest. This view may be revised, however, as more experience i s gained with new drugs in previously untreated patients.