Clinical pharmacology of lamotrigine.

Abstract:

:The pharmacokinetics and pharmacodynamics of lamotrigine (LTG), a new antiepileptic drug (AED), were studied in healthy volunteers. In an open dose-escalating study, LTG 240 mg produced peak plasma concentrations of around 3 micrograms/mg with no significant adverse events. Subsequent pharmacokinetic studies revealed complete oral absorption, first-order kinetics with a mean half-life of approximately 1 day, and elimination mainly as a glucuronide in the urine. Early studies in patients with epilepsy revealed more rapid metabolism when given with enzyme-inducing AEDs and delayed metabolism by valproate. A placebo-controlled, double-blind study compared LTG 120 and 240 mg with phenytoin (PHT) 500 and 1,000 mg, and diazepam (DZP) 10 mg. Visual analogue scales showed sedation after PHT 1,000 mg and DZP 10 mg, but not after LTG. Smooth pursuit eye movements and adaptive tracking were impaired by DZP and PHT 1,000 mg. LTG did not affect these variables. A comparison of LTG 150 and 300 mg and carbamazepine (CBZ) 200, 400, and 600 mg demonstrated impairment of smooth pursuit and saccadic eye movements by CBZ 600 and 400 mg, but not by LTG. Additionally, CBZ 600 mg impaired adaptive tracking and increased body sway and heart rate. These studies have shown LTG to have desirable and predictable pharmacokinetic properties for an AED. Pharmacodynamic effects were absent, suggesting a high therapeutic index.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Peck AW

doi

10.1111/j.1528-1157.1991.tb05883.x

subject

Has Abstract

pub_date

1991-01-01 00:00:00

pages

S9-12

eissn

0013-9580

issn

1528-1167

journal_volume

32 Suppl 2

pub_type

临床试验,杂志文章,评审
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    abstract:PURPOSE:To determine prevalence of active epilepsy in school children in a defined area and assess the usefulness of International League Against Epilepsy classification of seizures and epileptic syndromes, with special emphasis on frequency, additional handicaps, and therapeutic problems of severe cases. METHODS:The ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.2000.tb00246.x

    authors: Waaler PE,Blom BH,Skeidsvoll H,Mykletun A

    更新日期:2000-07-01 00:00:00

  • Influence of therapeutic phenobarbital and phenytoin medication on the polygraphic sleep of patients with epilepsy.

    abstract::Sleep is a modulator of seizure activity, and many antiepileptic drugs are modulators of sleep. Can influences on sleep organization be involved in antiepileptic drug action, and can these partly account for differences in drug response of various epileptic syndromes? Much more exact data must be collected before thes...

    journal_title:Epilepsia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1528-1157.1984.tb03445.x

    authors: Wolf P,Röder-Wanner UU,Brede M

    更新日期:1984-08-01 00:00:00

  • Effects of valproate on acylcarnitines in children with epilepsy using ESI-MS/MS.

    abstract:PURPOSE:To determine the influence of valproate (VPA) treatment on acylcarnitines in children with epilepsy. METHODS:Determination of acylcarnitines (including free carnitine and acylcarnitines from C2 to C18) in dried blood spot specimens using tandem-mass spectrometry. Longitudinal study of changes in acylcarnitines...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2006.00833.x

    authors: Werner T,Treiss I,Kohlmueller D,Mehlem P,Teich M,Longin E,Gerstner T,Koenig SA,Schulze A

    更新日期:2007-01-01 00:00:00

  • Lennox-Gastaut syndrome with late-onset and prominent reflex seizures in trisomy 21 patients.

    abstract:PURPOSE:Lennox-Gastaut syndrome (LGS) is a severe epileptic condition characterized by multiple seizure types including tonic seizures, slow spike-and-wave discharges on electroencephalography (EEG), and cognitive impairment. LGS can occur in apparently healthy subjects or in patients with preexisting brain damage. The...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2008.01944.x

    authors: Ferlazzo E,Adjien CK,Guerrini R,Calarese T,Crespel A,Elia M,Striano P,Gelisse P,Bramanti P,di Bella P,Genton P

    更新日期:2009-06-01 00:00:00

  • The value of the number-needed-to-treat method in antiepileptic drug trials.

    abstract:PURPOSE:There is controversy between clinicians and statisticians on the appropriateness of the number needed to treat (NNT) as a summary statistic to report the effectiveness of a treatment. We examine the two viewpoints and make proposals concerning the reporting of clinical trial results. METHODS:In the context of ...

    journal_title:Epilepsia

    pub_type: 临床试验,杂志文章,meta分析,随机对照试验

    doi:10.1111/j.1528-1157.2000.tb00186.x

    authors: Lesaffre E,Boon P,Pledger GW

    更新日期:2000-04-01 00:00:00

  • Practice variability and efficacy of clonazepam, lorazepam, and midazolam in status epilepticus: A multicenter comparison.

    abstract:OBJECTIVE:Benzodiazepines (BZD) are recommended as first-line treatment for status epilepticus (SE), with lorazepam (LZP) and midazolam (MDZ) being the most widely used drugs and part of current treatment guidelines. Clonazepam (CLZ) is also utilized in many countries; however, there is no systematic comparison of thes...

    journal_title:Epilepsia

    pub_type: 杂志文章,多中心研究

    doi:10.1111/epi.13056

    authors: Alvarez V,Lee JW,Drislane FW,Westover MB,Novy J,Dworetzky BA,Rossetti AO

    更新日期:2015-08-01 00:00:00

  • Doublecortin expression in focal cortical dysplasia in epilepsy.

    abstract:PURPOSE:Doublecortin (DCX) is a microtubule-associated protein with regulatory roles in radial and tangential migration of neurons during cortical development. In normal adult cortex there is restricted expression, and DCX is widely used as a marker of neurogenesis. Imperfect corticogenesis is thought to underpin many ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2009.02194.x

    authors: Srikandarajah N,Martinian L,Sisodiya SM,Squier W,Blumcke I,Aronica E,Thom M

    更新日期:2009-12-01 00:00:00

  • The influence of electroencephalographic focus laterality on efficacy of carbamazepine in complex partial and secondarily generalized tonic-clonic seizures.

    abstract::Forty-five outpatients with chronic epilepsy with complex partial seizures (CPS) alone or associated with secondarily generalized tonic-clonic seizures (SGTCS) were treated with carbamazepine (CBZ) monotherapy. All patients had only a unilateral scalp electroencephalographic (EEG) focus. Left- (n = 29) and right- (n =...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1991.tb04713.x

    authors: Defazio G,Lepore V,Specchio LM,Pisani F,Livrea P

    更新日期:1991-09-01 00:00:00

  • Benzodiazepines in the acute management of seizures with autonomic manifestations: anticipate complications!

    abstract::The use of rescue benzodiazepines in the management of seizures is widely accepted in emergency pediatric practice. They can, however, cause severe side effects, such as respiratory depression. We describe five patients who presented with severe respiratory depression following benzodiazepine administration for seizur...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2011.03201.x

    authors: Lacroix L,Fluss J,Gervaix A,Korff CM

    更新日期:2011-10-01 00:00:00

  • Autoantibodies to neuronal antigens in children with new-onset seizures classified according to the revised ILAE organization of seizures and epilepsies.

    abstract:PURPOSE:Potentially pathogenic autoantibodies are found increasingly in adults with seizure disorders, including focal seizures and those of unknown cause. In this study, we investigated a cohort of children with new-onset seizures to see whether there were autoantibodies and the relationship to any specific seizure or...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.12405

    authors: Suleiman J,Wright S,Gill D,Brilot F,Waters P,Peacock K,Procopis P,Nibber A,Vincent A,Dale RC,Lang B

    更新日期:2013-12-01 00:00:00

  • Some facts about sleep relevant for Landau-Kleffner syndrome.

    abstract::Our understanding of the neural mechanisms of non-rapid eye movement sleep (NREM) is steadily increasing. Given the intriguing activation of paroxysmal activity during NREM sleep in patients with Landau-Kleffner syndrome (LKS), a thorough characterization of commonalities and differences between the neural correlates ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2009.02218.x

    authors: Mascetti L,Foret A,Bonjean M,Matarazzo L,Dang-Vu T,Maquet P

    更新日期:2009-08-01 00:00:00

  • Phasic GABAA -receptor activation is required to suppress epileptiform activity in the CA3 region of the immature rat hippocampus.

    abstract:PURPOSE:  Despite the consistent observation that γ-aminobutyric acid A (GABA(A) ) receptors mediate excitatory responses at perinatal stages, the role of the GABAergic system in the generation of neonatal epileptiform activity remains controversial. Therefore, we analyzed whether tonic and phasic GABAergic transmissio...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2012.03442.x

    authors: Kolbaev SN,Sharopov S,Dierkes PW,Luhmann HJ,Kilb W

    更新日期:2012-05-01 00:00:00

  • Spectrum of clinical and histopathologic responses to intracranial electrodes: from multifocal aseptic meningitis to multifocal hypersensitivity-type meningovasculitis.

    abstract:PURPOSE:We sought to characterize and compare the histopathologic and clinical changes elicited by subdural and depth electrodes in subjects undergoing epilepsy surgery evaluation. METHODS:A retrospective review of clinical records, imaging and histopathologic studies of epilepsy surgery cases requiring subdural strip...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1046/j.1528-1157.2001.042007895.x

    authors: Stephan CL,Kepes JJ,SantaCruz K,Wilkinson SB,Fegley B,Osorio I

    更新日期:2001-07-01 00:00:00

  • The assessment and treatment of concerns and anxiety in patients undergoing presurgical monitoring for epilepsy.

    abstract:PURPOSE:This study investigated the impact of a treatment information package on patients being monitored for possible surgical treatment for temporal lobe epilepsy. METHODS:One hundred patients were randomly assigned to either a high- or low-information preparation condition. Levels of anxiety were tested soon after ...

    journal_title:Epilepsia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1528-1157.1999.tb02037.x

    authors: Andrewes D,Camp K,Kilpatrick C,Cook M

    更新日期:1999-11-01 00:00:00

  • The development of intellectual abilities in pediatric temporal lobe epilepsy.

    abstract:PURPOSE:The aim of this study was to examine the impact of clinical variables, particularly age at onset of epilepsy, on intellectual function in a group of children with temporal lobe epilepsy (TLE). METHODS:We reviewed the preoperative neuropsychological test results of 79 children with unilateral TLE who subsequent...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2006.00904.x

    authors: Cormack F,Cross JH,Isaacs E,Harkness W,Wright I,Vargha-Khadem F,Baldeweg T

    更新日期:2007-01-01 00:00:00

  • Quality of life in psychogenic nonepileptic seizures.

    abstract:PURPOSE:Psychogenic nonepileptic seizures (PNESs) are events that alter or seem to alter the neurologic function and, in their appearance, resemble epileptic seizures (ESs). In patients with ESs the psychological and medical aspects of epilepsy greatly influence the health-related quality of life (HRQOL). The relation ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1046/j.1528-1157.2003.35302.x

    authors: Szaflarski JP,Hughes C,Szaflarski M,Ficker DM,Cahill WT,Li M,Privitera MD

    更新日期:2003-02-01 00:00:00

  • The effects of remifentanil on epileptiform discharges during intraoperative electrocorticography in patients undergoing epilepsy surgery.

    abstract:PURPOSE:High-dose i.v. opioids (e.g., alfentanil, 50 microg/kg bolus) are known to increase the intraoperative reading of epileptiform activity during epilepsy surgery (ES), thereby facilitating localization of the epileptogenic zone (i.e., the site of ictal onset and initial seizure propagation). However, this phenome...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1046/j.1528-1157.2001.05901.x

    authors: Wass CT,Grady RE,Fessler AJ,Cascino GD,Lozada L,Bechtle PS,Marsh WR,Sharbrough FW,Schroeder DR

    更新日期:2001-10-01 00:00:00

  • Transition issues for benign epilepsy with centrotemporal spikes, nonlesional focal epilepsy in otherwise normal children, childhood absence epilepsy, and juvenile myoclonic epilepsy.

    abstract::This chapter covers the syndromes of benign epilepsy with centrotemporal spikes (BECTS), nonlesional focal epilepsy in otherwise normal children (NLFN), and the genetic generalized epilepsies. BECTS is an epilepsy syndrome that always enters terminal remission before the general age of a planned transition of adolesce...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1111/epi.12706

    authors: Camfield CS,Berg A,Stephani U,Wirrell EC

    更新日期:2014-08-01 00:00:00

  • Cryptogenic late-onset epileptic spasms: an overlooked syndrome of early childhood?

    abstract:PURPOSE:Few reports detailing late-onset epileptic spasms have been published. To determine whether this condition merely represents a late variant of classic West syndrome or exhibits specific features distinct from the latter and related to a later stage of brain maturation, we analyzed the whole population with this...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2006.00518.x

    authors: Eisermann MM,Ville D,Soufflet C,Plouin P,Chiron C,Dulac O,Kaminska A

    更新日期:2006-06-01 00:00:00

  • Focal cortical dysplasia type IIb: completeness of cortical, not subcortical, resection is necessary for seizure freedom.

    abstract:PURPOSE:Focal cortical dysplasia type IIb (FCD IIb) lesions are highly epileptogenic and frequently cause pharmacoresistant epilepsy. Complete surgical resection leads to seizure freedom in most cases. However, the term "complete" resection is controversial with regard to the necessity of performing resections of the s...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2011.03158.x

    authors: Wagner J,Urbach H,Niehusmann P,von Lehe M,Elger CE,Wellmer J

    更新日期:2011-08-01 00:00:00

  • Hyperventilation revisited: physiological effects and efficacy on focal seizure activation in the era of video-EEG monitoring.

    abstract:PURPOSE:Hyperventilation is an activation method that provokes physiological slowing of brain rhythms, interictal discharges, and seizures, especially in generalized idiopathic epilepsies. In this study we assessed its effectiveness in inducing focal seizures during video-EEG monitoring. METHODS:We analyzed the effect...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.0013-9580.2005.11104.x

    authors: Guaranha MS,Garzon E,Buchpiguel CA,Tazima S,Yacubian EM,Sakamoto AC

    更新日期:2005-01-01 00:00:00

  • Nonconvulsive status epilepticus: high incidence of complex partial status.

    abstract::Nonconvulsive status epilepticus may be subdivided into generalized (absence) status and complex partial status. The latter is regarded as a rarity, whereas the former constitutes the dominant part of the hitherto reported cases. We report 10 consecutive cases of adult patients with nonconvulsive status epilepticus, a...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1986.tb03540.x

    authors: Tomson T,Svanborg E,Wedlund JE

    更新日期:1986-05-01 00:00:00

  • Plasticity of excitatory amino acid transporters in experimental epilepsy.

    abstract:PURPOSE:To examine the relationship between seizures and excitatory amino acid transporter (EAAT) activity and whether up-regulation of EAAT activity alters epileptogenicity. METHODS:In this study, we exposed rat hippocampal slices to different convulsants before measuring EAAT activity. Rats were exposed to the EAAT ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.2000.tb01567.x

    authors: Claudio OI,Ferchmin P,Velísek L,Sperber EF,Moshé SL,Ortiz JG

    更新日期:2000-01-01 00:00:00

  • Clobazam for treatment of intractable epilepsy: a critical assessment.

    abstract::Clobazam (CLB), a 1,5-benzodiazepine, is a remarkably effective add-on drug for individual patients with refractory partial epilepsy. CLB has an excellent safety record. As with all benzodiazepines used for treating epilepsy, sedation and withdrawal effects, together with the development of tolerance, limit its useful...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1111/j.1528-1157.1994.tb05979.x

    authors: Schmidt D

    更新日期:1994-01-01 00:00:00

  • Psychologic adaptation of children to epilepsy in a parent.

    abstract::A prospective study of the children in 12 families examined the impact of and adjustments to epilepsy in one of the parents. Young children allowed to see the parent's seizures and the treatment for those seizures adapted to the threat of illness in a parent by becoming involved in the care and supervision of the affe...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1984.tb04153.x

    authors: Lechtenberg R,Akner L

    更新日期:1984-02-01 00:00:00

  • Lamotrigine therapy of epilepsy with Angelman's syndrome.

    abstract:PURPOSE:Angelman syndrome (AS) is a neurogenetic disorder characterized by developmental delay and a frequently refractory epileptic condition. Valproate, clonazepam and/or phenytoin are said to be the most effective antiepileptic drugs (AEDs) against the seizures in AS. Experience with the newer AEDs is very limited d...

    journal_title:Epilepsia

    pub_type: 杂志文章,多中心研究

    doi:10.1111/j.1528-1167.2006.00969.x

    authors: Dion MH,Novotny EJ Jr,Carmant L,Cossette P,Nguyen DK

    更新日期:2007-03-01 00:00:00

  • Length of stay for patients undergoing invasive electrode monitoring with stereoelectroencephalography and subdural grids correlates positively with increased institutional profitability.

    abstract:OBJECTIVE:Lowering the length of stay (LOS) is thought to potentially decrease hospital costs and is a metric commonly used to manage capacity. Patients with epilepsy undergoing intracranial electrode monitoring may have longer LOS because the time to seizure is difficult to predict or control. This study investigates ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.13737

    authors: Chan AY,Kharrat S,Lundeen K,Mnatsakanyan L,Sazgar M,Sen-Gupta I,Lin JJ,Hsu FPK,Vadera S

    更新日期:2017-06-01 00:00:00

  • Pharmacokinetics of phenylethylmalonamide (PEMA) in normal subjects and in patients treated with antiepileptic drugs.

    abstract::The pharmacokinetics of phenylethylmalonamide (PEMA), a major metabolite of primidone, were investigated following administration of single oral doses (400 mg) to six normal subjects and six patients receiving chronic treatment with antiepileptic drugs. Peak serum PEMA levels were usually attained with 2-4 h after int...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1982.tb06196.x

    authors: Cottrell PR,Streete JM,Berry DJ,Schäfer H,Pisani F,Perucca E,Richens A

    更新日期:1982-06-01 00:00:00

  • Posttraumatic epilepsy: the endophenotypes of a human model of epileptogenesis.

    abstract::Posttraumatic epilepsy is a common complication of traumatic brain injury (TBI), occurring in up to 15-20% of patients with severe brain trauma. Trauma accounts for approximately 5% of chronic epilepsy in the community. Because it is a common condition, and because of the relatively short latency period between injury...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1111/j.1528-1167.2008.02006.x

    authors: Diaz-Arrastia R,Agostini MA,Madden CJ,Van Ness PC

    更新日期:2009-02-01 00:00:00

  • Screening of major depression in epilepsy: the Neurologic Depression Disorders Inventory in Epilepsy-Spanish version (Argentina).

    abstract:OBJECTIVES:To validate and translate the English version of the Neurologic Depression Disorders Inventory in Epilepsy (NDDI-E) into Spanish as a screening instrument for major depressive episodes (MDE) for patients with epilepsy from Argentina and Uruguay. METHODS:One hundred fifty-five consecutive outpatients with ep...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.12503

    authors: Thomson AE,Calle A,Fontela ME,Yepez L,Muñoz Giacomelli F,Jáuregui A,Racosta JM,Kanner AM

    更新日期:2014-02-01 00:00:00