Lamotrigine monotherapy in children

The effectiveness of lamotrigine as a monotherapeutic agent for a variety o f pediatric epilepsies was reviewed retrospectively. Children were categori zed as having focal us generalized epilepsy and according to whether they w ere antiepileptic drug naive or drug exposed. Data collected included dosag es, side effects, length of follow-up, number of prior drugs, and treatment response. Treatment was considered successful if the patient was seizure f ree for 6 months or more. Eighty-three children were identified (average ag e = 8.7 years); 43 had focal epilepsy, 32 had generalized epilepsy, and eig ht were not classified. Twenty-nine patients were classified as having spec ific syndromes. Fourteen patients were drug naive. The median follow-up per iod was 8 months (mean = 8.5), Overall, 45% were seizure free, 44% with foc al epilepsy and 36% with generalized epilepsy. All children with juvenile m yoclonic epilepsy and benign rolandic epilepsy of childhood were seizure fr ee, although not all had been treated for at least 6 months. One third of d rug-naive patients were seizure free. Rash was the most common side effect and was reported in five patients (6%); two patients discontinued the drug. None had Stevens-Johnson syndrome, One quarter of children experienced non quantifiable improvements, namely increased alertness and improved behavior regardless of seizure control. Lamotrigine is effective as a monotherapeut ic agent in children for both focal and generalized epilepsies. Side effect s are relatively uncommon. Lamotrigine may be an effective firstline agent, (C) 2000 by Elsevier Science Inc, All rights reserved.