Abstracts

RATIONALE: To compare the quality of life in patients with epilepsy who switched from an older antiepileptic drug (AED) to lamotrigine (LTG) monotherapy with that of patients who switched to a different older AED. METHODS: Epilepsy patients ?16 years of age with any seizure type and taking one of the older AEDs (carbamazepine, phenytoin, or valproate) were randomly assigned to 24 weeks of LTG monotherapy or another older AED in an open-label randomized clinical trial. The Quality of Life in Epilepsy (QOLIE-31) questionnaire was administered at screening and the end of treatment (week 24). The QOLIE-31 is a validated questionnaire with seven multi-item scales: emotional well being; social functioning; energy/fatigue; cognitive functioning; seizure worry; medication effects; and overall quality of life. The last question, a visual analogue item, measured the patient's health perception. A higher overall score indicates better quality of life. RESULTS: The LTG (n=57) and older AED (n=58) treatment groups had similar demographic characteristics and seizure type and frequency at baseline. Clinical endpoints (e.g., mean time to withdrawal and seizure reduction) and safety results were comparable between treatment groups. However, patients switched to LTG monotherapy had significantly greater improvement in overall quality of life at week 24 than did patients switched to an older AED; the change in overall scores were 9.6 and 3.1, respectively (p=0.01). LTG recipients also had significantly better improvement (p?0.02) in cognitive functioning (12.4 vs 4.3), energy/fatigue (8.6 vs -0.4), medication effects (19.0 vs 4.2), patient's health perception (6.7 vs 0.2), and overall quality of life (6.2 vs -1.3). CONCLUSIONS: Results suggest that switching to LTG monotherapy from an older AED is associated with a better quality of life for patients with epilepsy, with notable improvements in cognitive functioning, energy/fatigue, overall quality of life, medication effects, and health perception.