Effectiveness of lamotrigine in clinical practice: results of a retrospective population-based study.
OBJECTIVE
Evaluation of the effectiveness of lamotrigine in a population-based cohort of epilepsy patients.


METHODS
Medical charts of 360 patients treated in 37 centres in The Netherlands were reviewed. Effectiveness of lamotrigine therapy was assessed during the first year of use, with patients serving as their own controls. Effectiveness was measured by reduction in seizure frequency and retention time.


RESULTS
Effectiveness could only be assessed in 165 patients; assessment in remaining patients was not possible due to various reasons, such as insufficient medical chart information. Lamotrigine was effective in 40% of patients who had been prescribed lamotrigine because of insufficient seizure control (n=112), and 14% of these 112 patients became seizure free. Duration of epilepsy, baseline seizure frequency, valproate use, drug load and number of antiepileptic drugs (AED) used were related to effectiveness of lamotrigine. In this group, 36% continued lamotrigine (LTG) throughout the first year without experiencing a >50% seizure reduction. Lamotrigine was effective in 63% of patients who received the drug because of poor tolerability of other antiepileptic drugs (n=53).


CONCLUSIONS
Lamotrigine is an effective drug in clinical practice. Use of retention time measures only may not correctly reflect the efficacy of antiepileptic drugs.
Knoester
P D
PD
Department of Clinical Pharmacy, University Medical Centre Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
Keyser
A
A
Renier
W O
WO
Egberts
A C G
AC
Hekster
Y A
YA
Deckers
C L P
CL
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D004347:Drug Interactions; D004827:Epilepsy / Q000145:classification / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use*; D014635:Valproic Acid / Q000627:therapeutic use
D000927:Anticonvulsants; D014227:Triazines; D014635:Valproic Acid; D000077213:Lamotrigine