Effectiveness and safety assessment of lamotrigine monotherapy for treatment of epilepsy

BACKGOUND: Epilepsy is a recurrent chronic nervous system disease. A correct choice of antiepileptic drug is the key to control seizures and improve patient's life quality. AIM: To study the effectiveness and safety of lamotrigine monotherapy for treatment of epilepsy, systemic evaluation was carried out on published comparative trials between lamotrigine and carbamazepine. METHODS: The retrieval method referred to the search strategy developed by Cochrane Epilepsy Group and software Rev.Man 5 was used for META analysis and forest plots.The Odds ratio (OR) was selected as the effect size and funnel plot was used to analyze the publication bias. RESULTS: A total of 9 studies and 2269 cases of patients were included in the analysis. There was no significant difference between lamotrigine and carbamazepine for treatment of epilepsy as the OR was 1.17, 95% confidence interval (CI) [0.88, 1.54]. However, lamotrigine had advantages in the overall withdrawal rate and withdrawal rate due to side effects as the ORs were 0.57, 95% CI [0.47, 0.69]) and 0.41, 95% CI [0.32, 0.52]. CONCLUSIONS: Lamotrigine has certain advantages over carbamazepine for treatment of epilepsy as it has less side effects and higher tolerability. In addition, the quality of such clinical trials should be further improved to have a more comprehensive understanding.