Titre
Lamotrigine serum levels: ceiling effect in people with epilepsy in remission?
Type
mémoire de master/maîtrise/licence
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Auteur(s)
D'ANTO, J.
Auteure/Auteur
Directrices/directeurs
ROSSETTI, A.
Directeur⸱rice
NOVY, J.
Codirecteur⸱rice
Liens vers les personnes
Liens vers les unités
Faculté
Université de Lausanne, Faculté de biologie et médecine
Statut éditorial
Accepté
Date de publication
2016
Nombre de pages
9
Langue
anglais
Résumé
Background
Antiepileptic drugs titration in epilepsy remains empirical. Since in practice seizure remission may be obtained with low doses, we aimed to determine if patients in remission have lower lamotrigine levels than those who continue experiencing seizures.
Methods
Retrospective analysis of the distribution of lamotrigine levels in people in remission and with ongoing seizures in a cohort. Remission was defined as the longest of either 3 times of the longest interseizure interval, or one year. Only through levels were considered.
Results
Between 2009 and 2014, we identified 93 adults, 10 were in remission. People in remission had significantly (p=0.018) lower serum levels (median 2.3 mg/l, range: 0.7-8.2) than those with ongoing seizures (median 5.4mg/l, range: 1.1- 18.2). We did not find any patient in remission with levels higher than 8.2 mg/l. Distribution of dosages also differed among the groups, but less significantly (p=0.03).
Conclusion
A correlation between lamotrigine serum levels and seizure response in term of remission appears to exist, and a ceiling level above which remission is unlikely is proposed. This could help to rationalise the titration of medication in drug- naïve patients with epilepsy.
Antiepileptic drugs titration in epilepsy remains empirical. Since in practice seizure remission may be obtained with low doses, we aimed to determine if patients in remission have lower lamotrigine levels than those who continue experiencing seizures.
Methods
Retrospective analysis of the distribution of lamotrigine levels in people in remission and with ongoing seizures in a cohort. Remission was defined as the longest of either 3 times of the longest interseizure interval, or one year. Only through levels were considered.
Results
Between 2009 and 2014, we identified 93 adults, 10 were in remission. People in remission had significantly (p=0.018) lower serum levels (median 2.3 mg/l, range: 0.7-8.2) than those with ongoing seizures (median 5.4mg/l, range: 1.1- 18.2). We did not find any patient in remission with levels higher than 8.2 mg/l. Distribution of dosages also differed among the groups, but less significantly (p=0.03).
Conclusion
A correlation between lamotrigine serum levels and seizure response in term of remission appears to exist, and a ceiling level above which remission is unlikely is proposed. This could help to rationalise the titration of medication in drug- naïve patients with epilepsy.
Sujets
PID Serval
serval:BIB_B865071354EF
Date de création
2017-09-05T11:48:22.966Z
Date de création dans IRIS
2025-05-20T22:18:37Z
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Nom
Mémoire no 3246 Mme D'Anto.pdf
Version du manuscrit
imprimatur
Taille
82.3 KB
Format
Adobe PDF
PID Serval
serval:BIB_B865071354EF.P001
URN
urn:nbn:ch:serval-BIB_B865071354EF4
Somme de contrôle
(MD5):69c24a95ac4b5242dd70371da99a538a