Lamotrigine serum levels: ceiling effect in people with epilepsy in remission?

Details

Ressource 1Download: Mémoire no 3246 Mme D'Anto.pdf (82.30 [Ko])
State: Public
Version: After imprimatur
Serval ID
serval:BIB_B865071354EF
Type
A Master's thesis.
Publication sub-type
Master (thesis) (master)
Collection
Publications
Institution
Title
Lamotrigine serum levels: ceiling effect in people with epilepsy in remission?
Author(s)
D'ANTO J.
Director(s)
ROSSETTI A.
Codirector(s)
NOVY J.
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2016
Language
english
Number of pages
9
Abstract
Background
Antiepileptic drugs titration in epilepsy remains empirical. Since in practice seizure remission may be obtained with low doses, we aimed to determine if patients in remission have lower lamotrigine levels than those who continue experiencing seizures.
Methods
Retrospective analysis of the distribution of lamotrigine levels in people in remission and with ongoing seizures in a cohort. Remission was defined as the longest of either 3 times of the longest interseizure interval, or one year. Only through levels were considered.
Results
Between 2009 and 2014, we identified 93 adults, 10 were in remission. People in remission had significantly (p=0.018) lower serum levels (median 2.3 mg/l, range: 0.7-8.2) than those with ongoing seizures (median 5.4mg/l, range: 1.1- 18.2). We did not find any patient in remission with levels higher than 8.2 mg/l. Distribution of dosages also differed among the groups, but less significantly (p=0.03).
Conclusion
A correlation between lamotrigine serum levels and seizure response in term of remission appears to exist, and a ceiling level above which remission is unlikely is proposed. This could help to rationalise the titration of medication in drug- naïve patients with epilepsy.
Keywords
Drug naïve, response to medication, therapeutic drug monitoring
Create date
05/09/2017 12:48
Last modification date
20/08/2019 15:26
Usage data