Abstracts

Most studies of anti-epileptic medications are conducted under somewhat artificial experimental conditions. This study assesses seizure efficacy and the mood and quality of life effects of lamotrigine (LTG) in a real-world clinical setting.
This is an ongoing prospective observational study. We recruited adult patients treated at the outpatient centers of the Long Island Jewish Comprehensive Epilepsy Center who were identified as appropriate candidates for LTG treatment by their epileptologists. Patients completed the Quality of Life in Epilepsy-31 inventory (QOLIE-31), the Profile of Mood States survey (POMS), and a seizure severity scale at baseline, 2 months, 6 months, and 1 year after beginning LTG, with the dosage titrated according to concomitant anti-epileptic medications.
Out of 60 patients enrolled, nine have completed the baseline evaluation and 1 year assessment after LTG initiation. Five patients had [gt]50% improvement in seizure control. Four patients had no change in seizure frequency. Data from completion at 6 months reported earler found patients demonstrated significant improvement (p[lt]0.05) in the QOLIE-31 scores, and significant improvement on subtests assessing emotional well-being, increased energy level, and increased social interaction. On the POMS, subsets showing significant improvement included: decreased anger, increased vigor, and decreased fatigue. In the 9 patients at one year, who completed the QOLIE-31, there was significant improvement (p[lt]0.013) in the QOLIE-31 Overall Score. There was also significant improvement on subtests assessing emotional well being, increased energy level, improved cognitive function, and decreased worry about seizures. In the 8 patients completing the POMS, subsets demonstrating significant improvement included: decreased anger, increased vigor, decreased fatigue, and decreased depression. From the 6 month to the one year interval, a trend toward significance (p[lt]0.06) was found in POMS subsets on increased vigor and decreased anger, and significant change was noted in decreased anxiety.
Data from this ongoing study indicate positive mood and quality of life effects that are sustained after the introduction of LTG. At one year, patients had improvement in more QOLIE-31 subsets compared to 6 months, and POMS subsets found more significant improvement at one year compared to 6 months, suggesting not only maintenance of these positive effects, but improvement over time.
[Supported by: GlaxoSmithKline]