THE EFFECT OF LAMOTRIGINE MONOTHERAPY AFTER
CONVERSION FROM THE COMBINED THERAPY LAMOTRIGINE
AND VALPROIC ACID IN PATIENTS WITH EPILEPSY
LIN CONG1*, YANG JIAO2, YAN DONG2
1Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, Harbin Heilongjiang150081,
People's Republic of China
2Department of Neurology Affiliated Hong Qi Hospital of Mu Dan Jiang Medical University, Mudanjiang Heilongjiang
157011 People's Republic of China
*corresponding author: drlinconglincong@163.com
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Abstract:
This study aimed to investigate the curative effect and safety profile of lamotrigine monotherapy converted from small doses
of lamotrigine (LTG) combined with valproic acid (VPA) in epileptic patients. The study included 40 patients with epilepsy
whose seizures were completely controlled after six months treatment with small doses of LTG combined with VPA. The
doses of VPA were gradually reduced till the patients were converted to LTG monotherapy. The patients were followed-up
on a period of six months. LTG plasma concentration, fasting blood glucose, fasting serum insulin, patients’ height and
weight were measured before converting from drug-combination treatment to monotherapy, a week after VPA was
withdrawn and six months after monotherapy. Long-term electroencephalogram (EEG) of 24 h was monitored before
converting to monotherapy and after six months’ follow-up visit. When VPA was withdrawn for a week and monotherapy
was adopted for six months, body mass index (BMI) decreased. There was no difference between insulin resistance indexes
according to the homeostasis model assessment (HOMA-IR) a week after VPA was withdrawn and before monotherapy.
However, after six months monotherapy, HOMA-IR lowered. No difference was observed in LTG plasma concentrations
before monotherapy, a week after VPA was withdrawn and six months after monotherapy. LTG plasma concentration during
the switch was higher than before monotherapy. Also, after the therapy conversion, the pharmacologic effect was stable, the
spontaneous recurrent seizures were rare, adverse reactions reduced and drug safety increased.






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