Women of child-bearing age
In a prospective, randomised study of emergence of components of polycystic ovary syndrome (PCOS) in a large, multinational population of women with epilepsy, women initially treated with valproate were more likely to display treatment-emergent PCOS and its components than were women initiating lamotrigine (LTG). This difference was driven by women who initiated treatment at age younger than 26 years.
In a study to determine the relative tolerability and efficacy of LTG and gabapentin (GBP), as compared with carbamazepine (CBZ) in older patients with epilepsy, the main limiting factor in patient retention was adverse drug reactions. Treatment terminations due to adverse events was lower for LTG when compared to CBZ and GBP (Terminations for adverse events: LTG 12.1%, GBP 21.6%, CBZ 31% (p<0.001). Significant paired comparisons: LTG vs CBZ: p<0.0001; LTG vs GBP: p<0.015). Seizure control was similar among groups. LTG and GBP should be considered as initial therapy for older patients with newly diagnosed seizures.
Lamictal is available in a range of formulations:
- Immediate-release (IR) tablets
- Dispersible/chewable tablets
- Orally disintegrating tablets (ODT)
Lamictal offers formulation options for different patients with epilepsy
Lamictal IR, Lamictal dispersible/chewable tablets and Lamictal ODT are indicated for use:
- In adults (over 12 years of age) as adjunctive therapy or monotherapy in the treatment of epilepsy, for partial or generalised seizures including tonic-clonic seizures and the seizures associated with Lennox-Gastaut syndrome
- As monotherapy in children (2-12 years of age) with typical absence seizures
- In children (2-12 years of age) as adjunctive therapy in the treatment of epilepsy, for partial seizures and generalised seizures including tonic-clonic seizures and the seizures associated with Lennox-Gastaut syndrome.
After epileptic control has been achieved during adjunctive therapy, concomitant antiepileptic drugs may be withdrawn and patients continued on lamotrigine IR monotherapy.
Lamictal is available in a range of doses
|IR tablets||25, 50, 100 and 200 mg|
|Dispersible/chewable tablets||2, 5, 25, 50, 100 and 200 mg|
|ODT||25, 50, 100 and 200 mg|
Should be swallowed whole and should not be chewed or crushed
May be chewed, dispersed in a small volume of water (at least enough to cover the whole tablet) or swallowed whole with a little water
Should be placed onto the tongue and moved around in the mouth. The tablet will disintegrate rapidly, can be swallowed with or without water and can be taken on a full or empty stomach
- Steinhoff BJ, Ueberall MA, Siemes H, Kurlemann G, Schmitz B, Bergmann L, et al. The LAM-SAFE Study: lamotrigine versus carbamazepine or valproic acid in newly diagnosed focal and generalised epilepsies in adolescents and adults. Seizure 2005; 14(8): 597–605.
- Marson AG, Al-Kharusi AM, Alwaidh M, Appleton R, Baker GA, Chadwick DW, et al. The SANAD study of effectiveness of carbamazepine, gabapentin, lamotrigine, oxcarbazepine, or topiramate for treatment of partial epilepsy: an unblinded randomised controlled trial. Lancet 2007; 369(9566): 1000–1015.
- Viteri C, Codina M, Cobaleda S, Lahuerta J, Barriga J, Morales MD, et al. Quality of life and treatment satisfaction in Spanish epilepsy patients on monotherapy with lamotrigine or valproic acid. Seizure 2010; 19(7): 432–438.
- Morrell MJ, Hayes FJ, Sluss PM, Adams JM, Bhatt M, Ozkara C, et al. Hyperandrogenism, ovulatory dysfunction, and polycystic ovary syndrome with valproate versus lamotrigine. Ann Neurol 2008; 64(2): 200–211.
- Rowan AJ, Ramsay RE, Collins JF, Pryor F, Boardman KD, Uthman BM, et al. New onset geriatric epilepsy: a randomized study of gabapentin, lamotrigine, and carbamazepine. Neurology 2005; 64(11): 1868–1873.
- Lamictal Summaries of Product Characteristics available at www.medicines.ie.