Levetiracetam and lamotrigine in old aged onset of epilepsy: a randomized double-blind clinical trial

Choosing the right drug with the least side effects and highest effectiveness for the control of seizures in the elderly is important. The aim of this study was compare the efficacy of lamotrigine and levetiracetam in the management of epilepsy in the elderly. This study was performed as a double-blind randomized clinical trial in patients that referred to the neurologic clinic at Sina University Hospital، Tehran، Iran in 2012. The patients over sixty years old with a diagnosis of epilepsy were selected. They had one seizure in year at least and one attack in the last 6 months. First، the patients divided to two groups; Group one were treated with lamotrigine، 25 mg per day and group two were treated with levetiracetam، 250 mg per day for 24 weeks. In the absence of drug complications، the dose was increased to the maximum dose listed in the treatment protocol. Second the patients were followed in number of attacks، abnormalities in laboratory data and side effects of drug in 2، 4، 8، 12 and 20 weeks. The collecting data of the study were analyzed using descriptive and analytical statistics methods. Forty nine cases، 28 males and 21 females in lamotrigine group and 46 cases in levetiracetam group، 27 males and 19 females participated in the final analysis. Mean age of patients was 72. 40±5. 87 (63-85). Drug side effects were observed in 57 cases، 26 cases of lamotrigine group and 31 cases of levetiracetam group. Seizure frequency showed a declining trend in both groups but in lamotrigine group more than levetiracetam group in last week (P= 0. 039). The findings of the study showed lamotrigine and levetiracetam were effective in management of epilepsy in the elderly. Levetiracetam has a higher seizure-free effect than lamotrigine but lamotrigine is better tolerated than levetiracetam.