Objective: To explore the efficacy and safety of the combined therapy of valproic acid (VPA) and lamotrigine (LTG) for various types of epilepsy.
Methods: The patients were recruited from the epilepsy center at Affiliated Tongji Hospital, Tongji Medical College, Huazhong Science & Technology University from January 2009 to September 2011. They were randomly selected through a number chart and divided into two groups: child group and adult group. The prospective follow-up study lasted for one year to examine the long-term efficacy and safety of combined therapy. Seizure frequency was recorded at Months 3, 6 and 12. The changes of seizure frequency were analyzed to calculate the 50% response rate, 75% response rate and seizure-free rate. All side effects during therapy were recorded. The correlation of efficacy with seizure type was also examined. Statistical analysis was performed through t test, variance analysis and χ(2) test.
Results: Among a total of 134 patients, 10 of them withdrew. At Months 3, 6 and 12, as compared with baseline, the average reduction rate of seizure frequency per month was 56%, 62%, 70% in child group versus 74%, 82%, 85% in adult group (P < 0.05). Adult group was better than child group. At Month 3, 50% response rate, 75% response rate and seizure-free rate was 70.97% - 35.48% in child group versus 83.87% - 43.01% in adult group. When compared at Months 3, 6 and 12, 50% response rate, 75% response rate and seizure-free rate showed no statistical difference (P > 0.05). The worse outcomes occurred more frequently in the patients with complex partial seizure (CPS) and than those with simple partial seizure (SPS) and generalized seizure GS (P < 0.05). Rash was the major side effect for withdrawal.
Conclusion: The co-medication of VPA and LTG is both effective and safe for all epileptic types, especially for SPS and GS. And the efficacy may last for up to one year. Combined therapy shows excellent safety.