Antiepileptic Lamictal Monotherapy: Goals, Results, Conclusion

lamictalEpilepsy is a common neurologic disease in which abnormal electrical discharges in the brain cause repeated seizures. Approximately 70% of patients with epilepsy take one antiepileptic drug that can prevent generalized or partial seizures – Lamictal (Lamotrigine).

This review is applicable to patients with partial seizures (with or without secondary generalization) and patients with generalized tonic-clonic seizures, a special type of generalized seizures. This review is not applicable to patients with other types of generalized seizures, such as absence or myoclonic seizures since they are recommended for another treatment.


Epilepsy medication Lamictal is the first line drug in patients with newly diagnosed epilepsy. The purpose of this review was to study the effectiveness of this drug in the control of seizures, as well as to search for the side effects that could lead to a withdrawal from taking medication.


The last tests were conducted in October 2016. We evaluated evidence from 13 randomized controlled trials that involved epilepsy medication lamotrigine. We were able to combine data on 2572 patients (9 out of 13 trials).


The results of the review show that in the early stages of treatment, patients are more likely to give up carbamazepine than Lamictal for epilepsy. The most common reason for refusing treatment was unfavorable events: 51% of refusals in participants taking carbamazepine and 36% of refusals in participants taking the maximum dose of lamotrigine for epilepsy. The second reason for refusal of treatment was the relapse of seizures: refusals of 56 participants from 683 who took carbamazepine (8%) and 93 participants from 610 who took lamotrigine dose for epilepsy (15%).

The results also suggest that after taking lamotrigine for epilepsy, recurrences of seizures may occur earlier than after using carbamazepine. A 6-month period without seizures with carbamazepine can be achieved earlier than with lamotrigine. Most patients who participated in 13 trials (88%) had partial seizures, and therefore the results of this review are applicable, first of all, to people with this type of seizures.

Most often participants reported the following lamotrigine side effects: dizziness, fatigue, gastrointestinal disorders, headaches and skin problems. These side effects were also reported by patients taking carbamazepine. The complete list of drugs is available for reading here –

Quality of evidence

We considered the quality of evidence for relapses and remissions of seizures in patients with partial seizures as high. The quality of evidence for refusal of treatment was estimated as moderate. The design of the studies (whether the patients and the treating physicians knew which medication was used) could affect the frequency of refusal of treatment. Up to 50% of patients in the included trials could be mistaken for suffering generalized seizures. We evaluated the quality of evidence for relapses and remissions of seizures in patients with generalized seizures as moderate, while the quality of evidence for refusal of treatment was considered low.


Lamictal (lamotrigine) is an effective treatment for partial seizures. However, before using this drug, you should carefully read the instructions and get more information on patients with generalized seizures. In addition, you need to pay special attention to identifying the types of seizures in order to ensure a high quality of the results.