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Study Suggests Lamotrigine Is Drug of Choice for Epilepsy

It is a cost-effective alternative to the standard drug treatment, carbamazepine

FRIDAY, March 23 (HealthDay News) -- Lamotrigine is a better, cost-effective alternative to the standard drug treatment for partial-onset epilepsy, carbamazepine, according to the results of a randomized trial of five different medications published in the March 24 issue of The Lancet.

Anthony G. Marson, M.D., of the University of Liverpool in the U.K., and colleagues conducted an unblinded, randomized, controlled trial of carbamazepine, gabapentin, lamotrigine, oxcarbazepine and topiramate in 1,721 patients recruited from hospital-based outpatient clinics in the United Kingdom. The study outcomes were time to treatment failure and 12-month remission.

Lamotrigine was a significantly better drug in terms of time to treatment failure compared to carbamazepine, gabapentin and topiramate. In terms of time to 12-month remission, carbamazepine performed better than gabapentin, while the results suggested it had an insignificant advantage over lamotrigine, topiramate and oxcarbazepine. When the data was analyzed to ascertain the proportion of patients who went into remission for 12 months, there was no advantage to using carbamazepine versus lamotrigine.

"Two further antiepileptic drugs have been licensed in the United Kingdom since this study was designed (levetiracetam and zonisamide), both of which are said to be effective in generalized epilepsies," the authors write. "The same question that applied to lamotrigine and topiramate now apply to these drugs, for which we need similarly robust comparative trials against valproate in similar populations of patients."

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