Clinical Effects Of Lamotrigine On Women Of Reproductive Age With Epilepsy

Epilepsy is one of the most common neurological disorders which severely affect thephysical and psychological health of human. The clinical features of epilepsy includerepeatable seizures, unpredictable onset, and long-term treatment. Now, antiepileptic drugs(AEDs) is still the main therapy for epilepsy. Due to the periodical secretion of hormonesand impacts of epilepsy and AEDS on reproductive organs and sexual hormones, thewomen of reproductive age with epilepsy always suffer more adverse effects during takingAEDS and have difficulties in pregnancy and fertility. Therefore, how to choose a kind ofAED that is effective in controlling seizures and has low side-effects for these women isan important problem for clinicians to solve. Lamotrigine (LTG) is a new broad-spectrumAEDS and has less impact on reproductive organs and hormones compared to traditionalAEDS, so it has been becoming the first choice for more women of reproductive age withepilepsy. However, as reports on relevant side effects of LTG including rash, fever, andsleepiness continue to emerge and the teratogenicity of LTG. Till now, the impact onpregnancy have still not been fully clarified, and lack of supports from national largesample trials. the curative effectiveness and pharmacy safety of the medicine need thesupport of more clinical studies. Objective: To evaluate the efficacy and safety of LTG in monotherapy of women ofreproductive age with epilepsy.Methods: With strict inclusion and exclusion criteria,120women patients aged15to49years were selected for the research which contained30patients with generalizedseizures and90with partial seizures. All of the patients took single LTG during the periodof observation.Drug administration: The oral dosage of LTG began at25mg/d and then wasincreased by25mg/d every7-14days according to the specific performance of everypatient till the maintaining dosage of100-200mg/d was reached.Observing items: The seizure frequency within3months following clinical stabilitywas recorded and compared with that within3months before taking the medicine. Thepatients underwent follow-up observations3months,6months,9months and12monthsafter taking medicine respectively, in which the blood routine test, liver function and renalfunction were examined as well. The pregnant women got normal prenatal examinations.Results: In the30patients with generalized seizures,24had over50%less of seizuresin3months after LTG dosage got stabilized (80.0%) and10had no seizure (33.3%).Among90patients with partial seizures,70had over50%less of seizures in3monthsafter LTG dosage got stabilized (77.8%) and27had no seizure during that time (30%). Onthe whole, the efficacy of LTG in all patients was about78.3%.We observed3pregnantwomen during follow-up period. The routine antenatal inspections of the3patients werenormal and their infants were health without malformation.33patients had mild adverseeffects (27.5%), which was ameliorated when the velocity of dosage escalation wasdecreased. No severe adverse effects happened during the observation. The retention rateof LTG in our research was about87.5%within a year.Conclusion: In the study, LTG monotherapy shows relative stable effects, highsafety and low influence on generalized seizures (except myoclonic seizures) and partialseizures for women of reproductive age with epilepsy. There are less effects of LTG on pregnancy and fertility, but the dosage should be adjusted timely according to the situationof every single patient. In the follow-up period,3infants had been born health withnormal development. The data of other patients were in the further long-term follow-up.