DOI: https://doi.org/10.22141/2224-0713.16.1.2020.197331

Features of lamotrigine use in the modern treatment of epilepsy

T.A. Litovchenko, O.Yu. Sukhonosova, S.M. Koreniev

Abstract


More than 70 million people worldwide suffer from epilepsy, a severe neurological disease that can affect life expectancy and lead to disability. Lamotrigine is a modern second-generation anti-epileptic drug. Compared to first-generation drugs (phenobarbital, phenytoin, primidone, carbamazepine, valproate), it has fewer side effects and better tolerability. The main mechanism of action of lamotrigine is related to the blockade of sodium channels. In addition, effects on calcium channels, GABAergic, serotonergic effects are known. The integrated mechanism of action causes a wide range of indications for epilepsy, i.e. the possibility of relief of both generalized and focal attacks. Lamotrigine is characterized by linear pharmacokinetics. It is rapidly and well absorbed when taken orally: total oral bioavailability is 98 %, peak plasma concentrations is reached 1–3 h after ingestion. Today, lamotrigine has a convincingly proven effectiveness as an anti-epileptic drug (both alone and in combination therapy) in primary generalized tonic-clonic, simple and complex partial, secondary generalized seizures, absences and atypical absences, myoclonic seizures, as well as in Lennox-Gastaut syndrome in patients aged 2 years and older. No less important is the fact that lamotrigine is also effective in psychiatric disorders associated with epilepsy: epileptic depression, epileptic dysphoria, epileptic psychoses, psychomotor and somatovegetative equivalents of attacks. Therefore, lamotrigine is one of the newest anti-epileptic drugs that is effectively used in the treatment of epilepsy in children and adults.

Keywords


epilepsy; lamotrigine; pharmacokinetics; features of use; adults; children

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