Valproate and Lamotrigine in Pediatric Patients With Refractory Epilepsy: After the First Year

Abstract The combination of lamotrigine and valproate/divalproex sodium has been shown to be effective in the treatment of refractory epilepsy. This study aims to evaluate the pharmacologic properties of using this combination in a pediatric population refractory to antiepileptic drugs, with an exte...

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Bibliographic Details
Published in:Pediatric neurology 2013-06, Vol.48 (6), p.436-442
Main Authors: Thome-Souza, Sigride, MD, PhD, Valente, Kette D., MD, PhD
Format: Article
Language:English
Subjects:
Adolescent
Anticonvulsants - therapeutic use
Child
Child, Preschool
Drug Therapy, Combination
Epilepsy - drug therapy
Epilepsy - etiology
Female
Humans
Longitudinal Studies
Male
Neurology
Pediatrics
Time Factors
Treatment Outcome
Triazines - therapeutic use
Valproic Acid - therapeutic use
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Summary:Abstract The combination of lamotrigine and valproate/divalproex sodium has been shown to be effective in the treatment of refractory epilepsy. This study aims to evaluate the pharmacologic properties of using this combination in a pediatric population refractory to antiepileptic drugs, with an extended follow-up. We studied a group of 51 patients, ranging from 4 to 16 years of age. Sixteen patients (31.4%) had generalized epilepsy and 35 (69.6%) had focal epilepsy. The combination was effective in 39 patients (76.5%) in the first year of follow-up and in 36 patients (70.6%) in the second year, with a reduction in drop attacks observed in 22 (88.5%). Adverse effects included rash, leading to discontinuation in four patients (7.8%). Slower introduction of lamotrigine minimizes adverse effects, thereby improving quality of life and adherence to treatment. In addition, therapeutic efficacy is maintained with lower doses of lamotrigine, even after the first year of treatment.
ISSN:0887-8994
1873-5150
DOI:10.1016/j.pediatrneurol.2013.01.005