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Literature DB >> 27630862

Valproic Acid versus Lamotrigine as First-line Monotherapy in Newly Diagnosed Idiopathic Generalized Tonic -Clonic Seizures in Adults - A Randomized Controlled Trial.

Vishal Prakash Giri¹, Om Prakash Giri², Farhan Ahmad Khan³, Narendra Kumar⁴, Ajay Kumar⁵, Ataul Haque⁶.

Abstract

INTRODUCTION: Idiopathic Generalized Tonic-Clonic Seizures (GTCS) are frequently encountered in adults. Their successful control is necessary to improve the quality of life of these patients. Valproic acid is a simple branched-chain carboxylic acid and lamotrigine is a phenyltriazine derivative. Opinions differ in regards to their effectiveness in idiopathic GTCS. AIM: To compare the effectiveness of valproic acid and lamotrigine in newly diagnosed adults with idiopathic generalized tonic-clonic seizures.
MATERIALS AND METHODS: The present prospective randomized study was conducted on 60 patients suffering from idiopathic GTCS. Thirty patients received valproic acid and rest 30 patients received lamotrigine. All patients were followed regularly monthly for one year for treatment response and adverse effects.
RESULTS: After 12 months follow-up, 76.67% patients taking valproic acid and 56.67% patients taking lamotrigine were seizure-free. Common adverse effects recorded were nausea, dyspepsia, headache and skin rash.
CONCLUSION: Valproic acid is more effective than lamotrigine as first-line drug in the treatment of adults with newly diagnosed idiopathic generalized tonic-clonic seizures.

Entities: Chemical Disease Species

Keywords: Antiepileptic drugs; Clinical trial; Effectiveness; Epilepsy; Monotherapy

Year: 2016 PMID： 27630862 PMCID： PMC5020233 DOI： 10.7860/JCDR/2016/16911.8121

Source DB: PubMed Journal: J Clin Diagn Res ISSN： 0973-709X

14 in total

1. The LaLiMo Trial: lamotrigine compared with levetiracetam in the initial 26 weeks of monotherapy for focal and generalised epilepsy--an open-label, prospective, randomised controlled multicenter study.

Authors: Felix Rosenow; Carmen Schade-Brittinger; Nicole Burchardi; Sebastian Bauer; Karl Martin Klein; Yvonne Weber; Holger Lerche; Stefan Evers; Stjepana Kovac; Susanne Hallmeyer-Elgner; Götz Winkler; Joachim Springub; Mathias Niedhammer; Erhard Roth; Ilonka Eisensehr; Jörg Berrouschot; Stephan Arnold; Michael Schröder; Anja Beige; Wolfgang H Oertel; Adam Strzelczyk; Anja Haag; Philipp S Reif; Hajo M Hamer
Journal: J Neurol Neurosurg Psychiatry Date: 2012-05-17 Impact factor: 10.154

2. Epilepsy: new advances.

Authors: Solomon L Moshé; Emilio Perucca; Philippe Ryvlin; Torbjörn Tomson
Journal: Lancet Date: 2014-09-24 Impact factor: 79.321

3. A method for estimating the probability of adverse drug reactions.

Authors: C A Naranjo; U Busto; E M Sellers; P Sandor; I Ruiz; E A Roberts; E Janecek; C Domecq; D J Greenblatt
Journal: Clin Pharmacol Ther Date: 1981-08 Impact factor: 6.875

4. Long-term efficacy of valproate versus lamotrigine in treatment of idiopathic generalized epilepsies in children and adolescents.

Authors: Maria Mazurkiewicz-Bełdzińska; Marta Szmuda; Agnieszka Matheisel
Journal: Seizure Date: 2010-02-18 Impact factor: 3.184

5. Sodium valproate versus lamotrigine: a randomised comparison of efficacy, tolerability and effects on circulating androgenic hormones in newly diagnosed epilepsy.

Authors: Linda J Stephen; Graeme J Sills; John Paul Leach; Elaine Butler; Pamela Parker; Nikolas Hitiris; Veronica M Leach; Elaine A Wilson; Martin J Brodie
Journal: Epilepsy Res Date: 2007-06-05 Impact factor: 3.045

6. The relationship between treatment with valproate, lamotrigine, and topiramate and the prognosis of the idiopathic generalised epilepsies.

Authors: A Nicolson; R E Appleton; D W Chadwick; D F Smith
Journal: J Neurol Neurosurg Psychiatry Date: 2004-01 Impact factor: 10.154

Review 7. ILAE official report: a practical clinical definition of epilepsy.

Authors: Robert S Fisher; Carlos Acevedo; Alexis Arzimanoglou; Alicia Bogacz; J Helen Cross; Christian E Elger; Jerome Engel; Lars Forsgren; Jacqueline A French; Mike Glynn; Dale C Hesdorffer; B I Lee; Gary W Mathern; Solomon L Moshé; Emilio Perucca; Ingrid E Scheffer; Torbjörn Tomson; Masako Watanabe; Samuel Wiebe
Journal: Epilepsia Date: 2014-04-14 Impact factor: 5.864

8. Lamotrigine inhibits postsynaptic AMPA receptor and glutamate release in the dentate gyrus.

Authors: Chun-Yao Lee; Wen-Mei Fu; Chih-Chuan Chen; Ming-Jai Su; Horng-Huei Liou
Journal: Epilepsia Date: 2008-01-29 Impact factor: 5.864

9. The SANAD study of effectiveness of valproate, lamotrigine, or topiramate for generalised and unclassifiable epilepsy: an unblinded randomised controlled trial.

Authors: Anthony G Marson; Asya M Al-Kharusi; Muna Alwaidh; Richard Appleton; Gus A Baker; David W Chadwick; Celia Cramp; Oliver C Cockerell; Paul N Cooper; Julie Doughty; Barbara Eaton; Carrol Gamble; Peter J Goulding; Stephen J L Howell; Adrian Hughes; Margaret Jackson; Ann Jacoby; Mark Kellett; Geoffrey R Lawson; John Paul Leach; Paola Nicolaides; Richard Roberts; Phil Shackley; Jing Shen; David F Smith; Philip E M Smith; Catrin Tudur Smith; Alessandra Vanoli; Paula R Williamson
Journal: Lancet Date: 2007-03-24 Impact factor: 79.321

Valproic Acid versus Lamotrigine as First-line Monotherapy in Newly Diagnosed Idiopathic Generalized Tonic -Clonic Seizures in Adults - A Randomized Controlled Trial.

1. The LaLiMo Trial: lamotrigine compared with levetiracetam in the initial 26 weeks of monotherapy for focal and generalised epilepsy--an open-label, prospective, randomised controlled multicenter study.

2. Epilepsy: new advances.

3. A method for estimating the probability of adverse drug reactions.

4. Long-term efficacy of valproate versus lamotrigine in treatment of idiopathic generalized epilepsies in children and adolescents.

5. Sodium valproate versus lamotrigine: a randomised comparison of efficacy, tolerability and effects on circulating androgenic hormones in newly diagnosed epilepsy.

6. The relationship between treatment with valproate, lamotrigine, and topiramate and the prognosis of the idiopathic generalised epilepsies.

Review 7. ILAE official report: a practical clinical definition of epilepsy.

8. Lamotrigine inhibits postsynaptic AMPA receptor and glutamate release in the dentate gyrus.

9. The SANAD study of effectiveness of valproate, lamotrigine, or topiramate for generalised and unclassifiable epilepsy: an unblinded randomised controlled trial.

Review 10. Antiepileptic Drug Treatment in Children with Epilepsy.

1. Sex differences in characteristics of idiopathic generalized epilepsies.

Review 2. Intractable Generalized Epilepsy: Therapeutic Approaches.

Review 3. Genetic generalized epilepsies in adults - challenging assumptions and dogmas.

Review 4. Antiepileptic drug monotherapy for epilepsy: a network meta-analysis of individual participant data.

5. Effects of Low- and High-Dose Valproic Acid and Lamotrigine on the Heart in Female Rats.

6. Psychomotor development and seizure features in idiopathic myoclonic epilepsy in infancy.