Cochrane review of lamotrigine as add-on therapy for drug-resistant focal epilepsy

  • Panebianco M & al.
  • Cochrane Database Syst Rev
  • 20 Mar 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • In patients with drug-resistant focal epilepsy, addition of lamotrigine to conventional antiepileptic drugs (AEDs) was effective in reducing seizure frequency and was fairly well-tolerated.

Why this matters

  • Findings warrant high-quality research to evaluate the long-term efficacy and tolerability of lamotrigine and to compare it with newer AEDs.

Study design

  • Updated Cochrane review of 14 randomised controlled trials including 1806 eligible participants (38 infants, 199 children, and 1569 adults).
  • Funding: The National Institute for Health Research.

Key results

  • Moderate-certainty evidence suggested that lamotrigine vs placebo was significantly more effective in reducing seizure frequency (≥50% reduction; risk ratio [RR], 1.80; 95% CI, 1.45-2.23) and treatment withdrawal because of any reason (RR, 1.11; 95% CI, 0.91-1.37).
  • Lamotrigine vs placebo group had a significantly increased risk for adverse events as follows:
    • ataxia (RR, 3.34; 95% CI, 2.01-5.55);
    • dizziness (RR, 2.00; 95% CI, 1.52-2.64);
    • diplopia (RR, 3.79; 95% CI, 2.15-6.68); and
    • nausea (RR, 1.81; 95% CI, 1.22-2.68).

Limitations

  • Risk of bias.