Comparison of levetiracetam and lamotrigine in late-onset epilepsy

Purpose: To compare the efficacy and safety of add-on treatment of levetiracetam (LEV) and lamotrigine (LTG) in elderly patients with epilepsy. Methods: LEV or LTG were randomly assigned (1:1) to aged epilepsy patients clinically uncontrolled on antiepileptic drug (AED) monotherapy regimens. Patients were assessed fora 12 month followup period by means of diaries, side-effect scales, EEG and neuropsychological tasks. Results: At 12 month evaluation 5 (25%) patients undergoing LEV and 2 (10%) undergoing LTG were seizure-free. Seizure reduction > 50% was seen in 14 of 20 (70%) patients receiving LEV and in 4 of 20 (20%) receiving LTG. 2 patients premature1y discontinued LEV due to side effects an d 5 discontinued LTG for lack of efficacy or side effects. At the end of the study seizure-free subjects, after discontinuation of the first AED, underwent a further 12 month monotherapy follow-up. Conclusion: Our evidence suggests that efficacy/safety of LEV in elderly patients may be in some instances superior to those observed far LTG. LEV could also have substantial potential use in the elderly as monotherapy proposal because of its easy and fast titration and lack of drug interactions.