Efficacy, tolerability, and kinetics of lamotrigine in infants

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• 作者：Mohamad A. Mikati ; Michel Fayad ; Majed Koleilat ; Nabil Mounla ; Rania Hussein ; Alia Kazma ; Khalid Yunis
• 刊名：The Journal of Pediatrics
• 出版年：2002
• 出版时间：July 2002
• 年：2002
• 卷：141
• 期：1
• 页码：31-35
• 全文大小：68 K

文摘

Objectives: To investigate the efficacy, tolerability, and kinetics of lamotrigine during the first year of life. Study design: We studied 13 infants with intractable seizures; 7 had partial seizures and 7 had infantile spasms (1 had both). Patients received open-label lamotrigine as add-on therapy for 3 months. Seizure frequency, response ratio, and side effects score were determined and compared with the baseline period. Results: The rate of partial seizures per day decreased from 8.57 ± 2.29 to 4.00 ± 2.15 (P = .027) and infantile spasms from 8.71 ± 2.15 to 3.61 ± 2.762 (P = .028). Apparent clearance increased during the first year of life, with a break point at 2 months of age (mean, 0.119 ± 0.021, 0.217 ± 0.094 L/h per kilogram for infants <2 months and those 2 to 12 months old, respectively,P < .001). Twenty-four-hour concentration to time plots of three 3- to 4-week-old neonates showed a half-life of 23.44 ± 3.57 hours. Compared with a group of 17 older children, LTG had similar efficacy (response ratios, −0.68 ± 0.12 and −0.74 ± 0.11, P = .504), and similar adverse effects scores (0.67 ± 0.67 and 0.23 ± 0.166, P = .95). Conclusions: Lamotrigine is a useful and well tolerated drug for partial seizures and infantile spasms in infants <1 year of age. However, lamotrigine has age-dependent kinetics that must be taken into consideration. (J Pediatr 2002;141:31-5)