Efficacy, safety, and potential of extended-release lamotrigine in the treatment of epileptic patients

Neuropsychiatr Dis Treat. 2010 May 6:6:145-50. doi: 10.2147/ndt.s6515.

Abstract

Epilepsy is a frequent, chronic disease demanding long-term medication with antiepileptic drugs (AEDs). When slow release formulations of AEDs are used the chance of compliance and control of seizures is increased. Lamotrigine (LTG) is a broad spectrum antiepileptic drug (AED), effective against both generalized and partial seizures. Its immediate-release formulation (LTG-IR) requires twice-daily dosing. In contrast, an extended-release formulation (LTG-XR) may be given once daily, providing a flatter dose-concentration curve with apparently lower maximum serum levels. Simplified dosing positively affects compliance and LTG-XR has a similar profile of efficacy and tolerability to LTG-IR. Rashes, including Stevens-Johnson syndrome, are the most serious adverse effect impacting 0.8% of pediatric patients. Thus, LTG-XR should be discontinued upon the appearance of rash.

Keywords: adverse reactions; antiepileptic drugs; epilepsy; extended-release; lamotrigine; pharmacokinetics; tolerability.