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Long-term use of GABAPENTIN, LAMOTRIGENE and VIGABATRIN in Patients with chronic epilepsy.

ICK Wong et Al, Epilepsia 40(10): 1439-1445

This is a retrospective study on 1375 patients.

361 were taking Gabapentin

1050 were taking Lamotrigene and

713 were taking Vigabatrin.

After 6 years less than 40% of the patients were still taking their initial medication.

Less than 4 % of them had become seizure free while taking one the medications.

The authors conclude that the impact of new AED s on chronic epilepsy is minimal.

Although these numbers may seem disappointing, the study does not tell us how many previous medications the patients had been on prior to enter the study, and we are only told that the duration of the epilepsy was one of the factors which had been adjusted for the calculation of the results. I feel that these patients were probably very difficult patients to treat and we do know that this population has a poor epileptic prognostic. The good news are that in chronic epilepsy when we keep trying new medications, there are still a small percentage of patients who eventually respond and therefore it is worth trying other drugs, and not give up.