| 카바마제핀 (Carbamazepine)을 복용중인 난치성 부분성 간질환자에서
Lamotrigine의 병용투여 효과 |
| 이병인, 박수철, 박형국, 김돈수, 옥 패트리샤, 김윤희 |
| 연세대학교 신경과, 순천향대학교 신경과, 한국 룻셀 주식회사, ?연세의료원 간질크리닉 |
| Add-On Therapy of Lamotrigine in Refractory Partial Epileptic Patients Taking Carbamazepine |
| Byung In Lee, M.D., Soo Chul Park, M.D., Hyung Kook Park, M.D., Don Soo Kim, M.D., Ok Patricia, M.D., Yun Hee Kim, R.N. |
| Department of Neurology, Younsei University and Soonchunhyang University, Russel Korea,Younsei University |
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| Abstract |
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Background : Lamotrigne (LTG) is a newly developed antiepileptic drug which has shown to'be effective for medically intractable partial seizures. LTG was recently introduced to Korea but its clinical efficacy has not been investigated yet.
Methods : We assigned 34 medically intractable localization related epileptic patients
taking maximally tolerable dose of carbarmazepine(CBZ). The study protocol consisted
of 12 weeks of baseline phase, 4 weeks of phase I (drug -adjustment phase) and 8
weeks o f phase II (maintenance of LTG 200mg/day) After phase II, eligible patients
entered into long-term therapy. Two patients dropped out during phase II for adverse
event (AE) in one, and AE and poor seizure control in the other.
Results : Intention to treat analysis of the seizure outcome after 12 weeks of LTG
add-on therapy showed mean seizure frequency reduction of 23.6% (p=O.006). More than
50% seizure frequency reduction was seen in 9 of 34 patients (26.4%), which was
comparable to the results of previous clinical trials. On the other hand, the incidence of
AE were quite high, which was developed in 27 patients. Dizziness with or without
blurred vision and/or diplopia were the most common AE and occurred in 64.7%, which
improved promptly by either reduction of CBZ or LTG doses.
Twenty-two patients entered into long-term therapy and 18 patients showed either
maintenance or more. LTG add-on therapy did not show any significant alterations of
baseline Lab. Tests.
Discussion : LTG was an effective and safe new antiepileptic drug. However, about
two-third of our patients developed A. E. similar to CBZtoxicity, which should be
carefully considerd for treating patients taking maximally tolerable CBZ therapy.
The proportion of patients taking LTG 300mg/day or more was very low in this study,
which suggested the racial difference of tolerability to LTG. |
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