Efficacy, safety, and potential of extended-release lamotrigine in the treatment of epileptic patients

Barbara Błaszczyk1,2, Stanisław J Czuczwar3,41Department of Neurology, Neuropsychiatric Hospital, Kielce, Poland; 2Faculty of Health Sciences, High School of Economics and Law, Kielce, Poland; 3Department of Pathophysiology, Medical University, Lublin, Poland; 4Department of Physiopathology, Institute of Agricultural Medicine, Lublin, PolandAbstract: Epilepsy is a frequent, chronic disease demanding long-term medication with antiepileptic drugs (AEDs). When slow release formulations of AEDs are used the chance of compliance and control of seizures is increased. Lamotrigine (LTG) is a broad spectrum antiepileptic drug (AED), effective against both generalized and partial seizures. Its immediate-release formulation (LTG-IR) requires twice-daily dosing. In contrast, an extended-release formulation (LTG-XR) may be given once daily, providing a flatter dose-concentration curve with apparently lower maximum serum levels. Simplified dosing positively affects compliance and LTG-XR has a similar profile of efficacy and tolerability to LTG-IR. Rashes, including Stevens–Johnson syndrome, are the most serious adverse effect impacting 0.8% of pediatric patients. Thus, LTG-XR should be discontinued upon the appearance of rash.Keywords: epilepsy, antiepileptic drugs, extended-release, lamotrigine, adverse reactions, tolerability, pharmacokinetics