Efficacy of lamotrigine in institutionalized, developmentally disabled patients with epilepsy: a retrospective evaluation

The paper evaluates the efficacy of the newer anticonvulsant lamotrigine in a developmentally disabled patient population. A retrospective evaluation was done at two institutional centres to assess adjunctive lamotrigine (Lam ictal(R)) efficacy in a developmentally disabled population. Mean seizure f requency was compared between a 2-month pre-lamotrigine baseline period and a 2-month treatment period. A 3-month lamotrigine titration phase occurred between baseline and treatment periods. Seizure frequency data was obtaine d from standardized, daily seizure records. Adverse effect data was obtaine d from medical and nursing notes. An intent to treat analysis was performed . Data were analysed using Student's t-test for paired data. We evaluated 4 4 centre residents (25 male, 19 female, average age 33 +/- 11 years). Mean lamotrigine dose was 272 +/- 133 mg per day. A significant reduction in sei zure frequency was noted. Seizure frequency tall seizures) was 10.1 +/-11.2 during the baseline period vs. 5.8 +/- 7.9 seizures per month during the t reatment period (P = 0.002). Thirty-two percent of patients (n = 14) had gr eater than a 75% reduction in seizure frequency. Twenty-three percent of pa tients (n = 10) had a 50-74% seizure reduction. Twenty five percent of pati ents (n = 11) had less than a 50% reduction in seizures, while 20% (n = 9) had an increase in seizures. A significant reduction of 48% in generalized seizures (9.5 +/- 11.6 vs. 4.9 +/- 6.5 seizures per month, P = 0.013) was n oted. Reductions in partial seizure frequency of 48% (7.9 +/- 10 vs. 4 +/- 6.6 seizures per month, P = 0.16) as well as in mixed-type seizures (19.9 /- 9.3 was vs. 15 +/- 12.1 seizures per month, P = 0.11) were also seen; ho wever, these changes did not reach significance. Overall, lamotrigine was w ell tolerated by the subject population. Adjunctive treatment with lamotrig ine appears to be an efficacious and well-tolerated treatment for seizures in a significant percentage of developmentally disabled patients with epile psy. (C) 2000 BEA Trading Ltd.