Sodium valproate versus lamotrigine: a randomised comparison of efficacy, tolerability and effects on circulating androgenic hormones in newly diagnosed epilepsy

Stephen, L. J., Sills, G. J., Leach, J. P. , Butler, E., Parker, P., Hitiris, N., Leach, V. M., Wilson, E. A. and Brodie, M. J. (2007) Sodium valproate versus lamotrigine: a randomised comparison of efficacy, tolerability and effects on circulating androgenic hormones in newly diagnosed epilepsy. Epilepsy Research, 75(2-3), pp. 122-129. (doi:10.1016/j.eplepsyres.2007.04.009) (PMID:17553671)

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Abstract

We have performed a randomised, prospective study to compare the efficacy and tolerability of sodium valproate (VPA) and lamotrigine (LTG) monotherapy, and their effects on circulating androgenic hormones, in newly diagnosed epilepsy. A total of 225 patients (116 male; median age 35 years, range 13–80 years) were followed-up at 6-weekly intervals until they reached an end-point (12 months’ seizure freedom; withdrawal due to intolerable side-effects; lack of efficacy despite adequate dosing). Twelve month seizure-free rates were identical (47%) in the VPA (n = 111) and LTG (n = 114) treatment arms. More patients taking VPA withdrew from the study due to adverse events (26 VPA versus 15 LTG; p = 0.046). Eight patients, all taking VPA, dropped out during the first 6 months due to weight gain. There were no changes in mean serum concentrations of testosterone, sex-hormone binding globulin and androstenedione or in the free androgen index after 6 or 12 months’ treatment with either drug in 112 patients who fulfilled the criteria for hormone analysis. No difference in efficacy was found between VPA and LTG in our patients with newly diagnosed epilepsy. LTG appeared to be better tolerated. Neither drug appeared to alter the circulating levels of androgenic hormones.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Brodie, Professor Martin and Butler, Mrs Elaine and Leach, Dr John Paul and Leach, Dr Veronica and Hitiris, Dr Nikolas and Stephen, Dr Linda and Sills, Dr Graeme
Authors: Stephen, L. J., Sills, G. J., Leach, J. P., Butler, E., Parker, P., Hitiris, N., Leach, V. M., Wilson, E. A., and Brodie, M. J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > School of Life Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Epilepsy Research
Publisher:Elsevier
ISSN:0920-1211
ISSN (Online):1872-6844

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