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From the Miami Children’s Hospital (Drs. Duchowny and Gilman), Miami, FL; The Medical College of Virginia (Dr. Pellock), Richmond, VA; Children’s Hospital and Medical Center (Dr. Graf), Seattle, WA; Hôpital de Clocheville (Dr. Billard), Tours, France; and GlaxoWellcome Research Institute (Drs. Casale, Risner, and Manasco and Ms. Womble), Research Triangle Park, NC.
Address correspondence and reprint requests to Dr. M. Duchowny, Miami Children’s Hospital, Room 302, Solomon Klein Pavilion, 3200 SW 62nd Court, Miami, FL 33155-4079.
OBJECTIVE: To compare the safety and efficacy of add-on lamotrigine and placebo in the treatment of children and adolescents with partial seizures.
BACKGROUND: Add-on and monotherapy lamotrigine is safe and effective in adults with partial seizures, and reports of preliminary uncontrolled trials suggest similar benefits in children.
METHODS: We studied 201 children with diagnoses of partial seizures of any subtype currently receiving stable conventional regimens of antiepileptic therapy at 40 study sites in the United States and France. After a baseline observation period (to confirm that more than four seizures occurred in each of two consecutive 4-week periods), patients were randomized to add-on lamotrigine or placebo therapy. A 6-week dose-escalation period was followed by a 12-week maintenance period.
RESULTS: Compared with placebo, lamotrigine significantly reduced the frequency of all partial seizures and the frequency of secondarily generalized partial seizures in these treatment-resistant patients. The most commonly reported adverse events in the lamotrigine-treated patients were vomiting, somnolence, and infection; the frequency of these and other adverse events was similar to that in the placebo-treated group, with the exception of ataxia, dizziness, tremor, and nausea, which were more frequent in the lamotrigine-treated group. The frequency of withdrawals for adverse events was similar between groups. Two patients were hospitalized for skin rash, which resolved after discontinuation of lamotrigine therapy.
CONCLUSIONS: Lamotrigine was effective for the adjunctive treatment of partial seizures in children and demonstrated an acceptable safety profile.
Key words: Lamotrigine—Pediatric—Epilepsy—Partial seizures.
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