The tolerability of lamotrigine in elderly patients with epilepsy.
OBJECTIVE
To determine the tolerability of lamotrigine in elderly patients with epilepsy.


METHODS
Pooled data from 13 lamotrigine clinical trials.


METHODS
Multicentre clinical trials conducted in primary care and neurology practices.


METHODS
208 elderly patients (aged > or = 65 years) were identified: 146 lamotrigine-treated patients, 53 carbamazepine-treated patients and 9 phenytoin-treated patients.


METHODS
Extent of exposure, incidence of drug-related adverse events, serious adverse events and study withdrawals were examined.


RESULTS
The median duration of exposure for lamotrigine monotherapy and add-on therapy was 24.1 and 47.4 weeks, respectively. The median daily dosage of lamotrigine was 100 mg for monotherapy (range 75 to 500 mg) and 300 mg for add-on therapy (range 25 to 700 mg). Overall, the incidence of drug-related adverse events was lower for lamotrigine than comparator drugs: 49% (72/146) for lamotrigine compared with 72% (38/53) for carbamazepine (p = 0.006), and 89% (8/9) for phenytoin (p = 0.035) although patient numbers in each treatment group were not comparable. Patients receiving lamotrigine reported incidences of somnolence (p = 0.012), rash (p = 0.034), and headache (nonsignificant) that were one-half the incidence reported with carbamazepine monotherapy. Rash was the most common reason for study withdrawal: 4% (6/146) lamotrigine, 17% (9/53) carbamazepine and 0% phenytoin. Seven (5%, 7/146) lamotrigine-treated patients, 4 (8%, 4/53) carbamazepine-treated patients and 1 (11%, 1/9) phenytoin-treated patient experienced drug-related serious adverse events.


CONCLUSIONS
Lamotrigine, used in the currently prescribed adult dosage regimen, was well tolerated in elderly patients with epilepsy.
Giorgi
L
L
Glaxo Wellcome plc, Greenford, Middlesex, United Kingdom.
Gomez
G
G
O'Neill
F
F
Hammer
A E
AE
Risner
M
M
D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D016208:Databases, Factual; D004361:Drug Tolerance; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D005853:Geriatrics; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D015337:Multicenter Studies as Topic; D012640:Seizures / Q000145:classification; D014227:Triazines / Q000009:adverse effects / Q000627:therapeutic use*
D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine