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© 2006 American Academy of Neurology Effect of lamotrigine on cognition in children with epilepsyFrom the Department of Clinical Neurophysiology (R.M.P., C.D.B., S.G.C., G.A.C.), King’s College Hospital, and Department of Pediatric Neurology (R.O.R.), Guy’s Hospital, London, UK. Address correspondence and reprint requests to Dr Pressler, Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK; e-mail: ronit.pressler{at}uclh.org Background: Lamotrigine does not affect cognition in healthy adult volunteers or adult patients with epilepsy, but its effect on cognition in children is uncertain. Objective: To compare the effect of lamotrigine and placebo on cognition in children with well-controlled or mild epilepsy. Method: In a double-blind, placebo-controlled, crossover study, 61 children with well-controlled or mild epilepsy were randomly assigned to add-on therapy with either lamotrigine followed by placebo or placebo followed by lamotrigine. Each treatment phase was 9 weeks, the crossover period 5 weeks. A neuropsychological test battery was performed during EEG monitoring at baseline and at the end of placebo and drug phases. The paired Student’ t test was used for statistical analysis for neuropsychological data (two tailed) with a p value of 0.01 considered significant. Carryover and period effect were analyzed with generalized linear modeling (SPSS 10). Results: Forty-eight children completed the study. Seizure frequency was similar during both treatment phases. No significant difference was found in continuous performance, binary choice reaction time, verbal and nonverbal recognition, computerized visual searching task, verbal and spatial delayed recognition, and verbal and nonverbal working memory between placebo and lamotrigine treatment phase. There was no significant carryover and period effect when corrected for randomization. Conclusion: Lamotrigine exhibits no clinically significant cognitive effects in adjunctive therapy for children with epilepsy.
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the May 23 issue to find the title link for this article. Disclosures: R. Pressler and G. Chorley were supported by grants from the Fund for Epilepsy and GlaxoSmithKline; otherwise, there are no conflicts of interest. Received June 16, 2005. Accepted in final form January 31, 2006.
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