Therapeutic use

Lamotrigine can be used as monotherapy or as additional therapy for patients whose seizures are resistant to first-line antiepileptic drugs.

Slow introduction of the drug is preferred by some:

• in patients taking sodium valproate:
  • begin with 25 mg on alternate days for 2 weeks,
  • then 25 mg/day for 2 weeks,
  • then increase stepwise to maintenance dose of 50-100 mg/day
    
    
• for other patients:
  • begin with 50 mg/day,
  • increase after 2 weeks to 50 mg bd,
  • then by 100 mg/day increments monthly as necessary to a maintenance dose of around 200 mg bd

If the drug is discontinued then it should be withdrawn slowly (to avoid the risk of rebound seizures). If the patient is taking sodium valproate then it should be reduced by 25 mg/week. If the patient is taking other anticonvulsants then reduction of 50-100 mg/week is recommended.

Before prescribing this medication the current doseage recommendations should be consulted.

Ref: Prescribers' Journal (1998), 38(2), 98-106.