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International Journal of Pharmacology
Year: 2009  |  Volume: 5  |  Issue: 5  |  Page No.: 313 - 318

A Randomized Open-Label Comparison of Lamotrigine and Valproate in Patients with Juvenile Myoclonic Epilepsy

S.E.M. Nejad, M.R.A. Nikpour, F. Rahim, S.N. Naghibi and M.A. Bahrammi    

Abstract: The aim of this study was to evaluate the efficacy and tolerability of lamotrigine and valproate in patients with different types of generalized epilepsy characterized by myoclonic seizures as well as compare the efficacy of those two drugs. A pilot, randomized controlled trial analysis of 46 female patients (age 8-30 years) in a large university hospital. All patients underwent several interictal EEG including routine awake and sleep EEGs. Lamotrigine was started at the dose of 500 mg day-1 and was progressively increased to a mean dose of 1500-2000 mg day-1 in a time course of 8 weeks. The target maintenance dose for valproate was 800 mg day-1 after starting valproate at the dose of 200 mg/12 h. The mean dose was reached within 4 weeks. Out of total 46 patients, 46 (100%) had juvenile myoclonic epilepsy; 43 (93.48%) had tonic-clonic; 5 (11%) had myoclonic absences. In the valproate and lamotrigine groups, there was significant reduction (p<0.001, p<0.001) in myoclonic seizure and tonic-clonic seizure frequencies. There was no clinically significant difference (p>0.05) between the effect of those two drugs that means the lamotrigine and valproate have similar effect in reducing the myoclonic seizure and tonic-clonic seizure frequencies. There was statistically significant effect (p<0.05) of those two drugs that means the lamotrigine and valproate also have significant effect in reducing the absences seizure frequency. The results suggest that lamotrigine monotherapy is a possible alternative for valproate among patients with juvenile myoclonic epilepsy who experienced unaccepted side effects or inadequate seizure control with valproate monotherapy.

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