title: The Effectiveness of Lamotrigine and Its Blood Levels for Pediatric Epilepsy.
abstract: This study was conducted to evaluate the effectiveness of lamotrigine (LTG) over 2 years and the usefulness of measuring its blood levels during the follow-up of patients with epilepsy. We measured peak blood LTG levels of 32 patients with epilepsy (9.16 ± 3.34 years old; mean ± SD). The blood levels were measured at 6 months, 1 year, and 2 years after reaching the LTG maintenance dosage. The effectiveness of LTG was evaluated to determine the seizure reduction rate. The patients were classified as effective cases (mean of own seizure reduction rates >50%) and ineffective cases (≤50%). The results were that the dosage and blood level showed positive correlations in the case of combination use with sodium valproate (VPA) (r = 0.690), carbamazepine and/or phenobarbital (r = 0.940), and others (r = 0.548). In several groups, the blood levels and efficacies did not show any positive correlations. In the cases of combination use with VPA, the blood levels of effective cases and ineffective cases were significantly different (P = 0.001). The optimal range was 8-11.5 μg/mL based on the average and SD values in the effective cases. No patients had any side effects. In conclusion, no precise definition of the therapeutic range was possible because of the incomplete correlation between the blood level and seizure frequency. We recommend the optimal range of LTG as a therapeutic target without any side effects, and it was established that the range in the combination with VPA was 8-11.5 μg/mL.
authors: Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
authors: Toshiyuki
authors: T
authors: Iwasaki
authors: Taira
authors: T
authors: Toki
authors: Yutaka
authors: Y
authors: Nonoda
authors: Masahiro
authors: M
authors: Ishii
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D002220:Carbamazepine / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D004359:Drug Therapy, Combination / Q000379:methods; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D010634:Phenobarbital / Q000494:pharmacology / Q000627:therapeutic use; D011446:Prospective Studies; D012640:Seizures / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome; D014227:Triazines / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D014635:Valproic Acid / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014227:Triazines; D002220:Carbamazepine; D014635:Valproic Acid; D000077213:Lamotrigine; D010634:Phenobarbital