The use of lamotrigine and other antiepileptic drugs in paediatric patients at a Malaysian hospital.
OBJECTIVE
(1) To determine the effect of lamotrigine add-on therapy on the seizure frequency and cost in paediatric patients. (2) To determine the prescribing pattern of other antiepileptic drugs (AEDs).


METHODS
A retrospective study of medical records was carried out from October 2000 to June 2001 at the paediatric clinic, Hospital Pulau Pinang.


METHODS
Seizure frequency, cost of drug and types of AED prescribed.


RESULTS
A total of 209 medical records were retrieved during the study period. Lamotrigine (LTG) was prescribed in 29 patients as add-on therapy. In 18 patients, there was a significant reduction in seizure frequency after the addition of LTG. Approximately 70% experienced a reduction in seizure frequency of more than 50%. Side effects of LTG were considered mild and manageable. However, drug cost after the addition of LTG increased by 103%. In the remaining 180 patients, the most common AED prescribed was sodium valproate (VPA). Only 15% of the patients received combination therapy. Mean monthly cost of monotherapy was found to be RM 24.4 while monthly cost of combination therapy was RM 45.4 (1 Euro-RM 5.00).


CONCLUSIONS
The majority of paediatric patients in the study are on AED monotherapy and only a small percentage was prescribed lamotrigine. The use of lamotrigine is associated with better seizure control but with an increase in drug cost.
Ab Rahman
Ab Fatah
AF
School of Pharmaceutical Sciences, Universiti Sains Malaysia, USM Pulau Pinang, Malaysia 11800. fatah@usm.my
Ibrahim
Mohamed Izham Mohamed
MI
Ismail
Hussain Imam Mohamed
HI
Seng
Tan Boon
TB
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000191:economics / Q000627:therapeutic use*; D002220:Carbamazepine / Q000191:economics / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D004827:Epilepsy / Q000188:drug therapy* / Q000191:economics; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008296:Malaysia; D008297:Male; D008499:Medical Records; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012640:Seizures / Q000517:prevention & control; D014227:Triazines / Q000191:economics / Q000627:therapeutic use*; D014635:Valproic Acid / Q000191:economics / Q000627:therapeutic use
D000927:Anticonvulsants; D014227:Triazines; D002220:Carbamazepine; D014635:Valproic Acid; D000077213:Lamotrigine