Lamotrigine as an add-on drug in typical absence seizures

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Abstract
Lamotrigine is licensed in many countries for use in patients with partial seizures. Evidence suggests that it may also be effective in generalised epilepsies. We analysed retrospectively our patients with idiopathic generalised epilepsy with refractory absences. Fifteen patients with idiopathic generalised epilepsies were identified who had been treated with lamotrigine for 3 months or more. All patients were also treated with sodium valproate. Fourteen patients had active absences. Nine (64%) had a total or virtual cessation of absences and in a further patient they became milder and less frequent. One patient reported an increase in seizures. The effective dose of lamotrigine was 1.6-3.0 mg/kg/day in children and 25-50 mg/day in adults. Patients who responded did so after the first or second dose. Lamotrigine was well tolerated. Low-dose lamotrigine added to sodium valproate appears to be effective in typical absence seizures. A therapeutic interaction of the two drugs seems likely.