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THE EFFECT OF LAMOTRIGINE MONOTHERAPY AFTER CONVERSION FROM THE COMBINED THERAPY LAMOTRIGINE AND VALPROIC ACID IN PATIENTS WITH EPILEPSY

LIN CONG ^1*, YANG JIAO ², YAN DONG ²

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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height and weight were measured before converting from drug-combination treatment to monotherapy, a week after VPA was withdrawn and six months after monotherapy.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 When VPA was withdrawn for a week and monotherapy was adopted for six months, body mass index (BMI) decreased.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between insulin resistance indexes according to the homeostasis model assessment (HOMA-IR) a week after VPA was withdrawn and before monotherapy.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 No difference was observed in LTG plasma concentrations before monotherapy, a week after VPA was withdrawn and six months after monotherapy.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.