Monotherapy of lamotrigine versus carbamazepine in patients with poststroke seizure.
OBJECTIVE
The incidence of seizures is known to be high in the elderly. The most common cause of an unprovoked seizure in the elderly population is stroke. These patients require effective and well-tolerated antiepileptic treatment because they frequently experience other medical conditions and use other medications that can interact with the antiepileptic treatment. The aim of the study was to analyze the tolerability and efficacy of lamotrigine (LTG) versus sustained-release carbamazepine (CBZ) treatment in newly diagnosed symptomatic poststroke seizure.


METHODS
Sixty-four patients with a first post episode of seizures were randomized in a 1:1 ratio to either LTG or CBZ treatment and were followed up prospectively for up to 12 months for efficacy and tolerability of the drugs.


RESULTS
More patients in the LTG group were seizure-free (72%) versus those in the CBZ group (44%; P = 0.06), but the numbers did not reach statistical significance because of a relative small number of study patients. The number of patients who withdraw from the study because of adverse events was statistically significantly less in the LTG group (3%) compared with the CBZ group (31%; P = 0.02).


CONCLUSIONS
The LTG treatment in poststroke seizures versus CBZ treatment is a relatively better-tolerated drug and can be acceptable as initial treatment in this specific group of patients.
Gilad
Ronit
R
Department of Neurology, Edith Wolfson Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Holon, Tel Aviv, Israel. gilad-ar@zahav.net.il
Sadeh
Menachem
M
Rapoport
Abraham
A
Dabby
Ron
R
Boaz
Mona
M
Lampl
Yair
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000627:therapeutic use*; D002220:Carbamazepine / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012640:Seizures / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D020521:Stroke / Q000150:complications; D016019:Survival Analysis; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use*
D000927:Anticonvulsants; D014227:Triazines; D002220:Carbamazepine; D000077213:Lamotrigine