"a comparative trial of lamotrigine and carbamazepine in patients with primary generalized tonic clonic seizures"

lamotrigine has been used widely in the treatment of partial and secondary generalized seizures. in this study use of lamotrigine as monotherapy for the newly diagnosed primary generalized tonic–clonic seizure has been investigated and compared with carbamazepine. after dose escalation (3 weeks for carbamazepine and 6 weeks for lamotrigin), patients were followed every 4 weeks for the first 16 weeks and then every 8 weeks for the next 32 weeks. total number of patients was 91, randomly divided in two groups, 46 patients in lamotrigine group and 45 patients in carbamazepine group. the efficacy of the two drugs against primary generalized tonic clonic seizure was almost the same. the proportion of patients with seizure episodes in the last 40 weeks of treatment in both groups was similar (24.2% versus 24.6%). overall, fewer patients in lamotrigine group than in the carbamazepine group withdrew because of adverse events (6.5% vs. 24.5%, p = 0.0216). the commonest side effect leading to withdrawal with lamotrigine was rash and with carbamazepine was drowsiness. more lamotrigine than carbamazepine recipients completed the study (88.9% vs. 73.3%, p = 0.0961). lamotrigine and carbamazepine showed similar efficacy against primary eneralized tonic clonic seizure in newly diagnosed epilepsy. lamotrigine, however, was better tolerated.