Dramatic Effect of Lamotrigine in Young Adults Suffering from Intractable Absences and Generalized Tonic–Clonic Seizures Since Childhood

The purpose of this study was to evaluate the efficacy of adding lamotrigine to valproic acid in patients with refractory absence seizures starting in childhood and persisting into adulthood. Lamotrigine was added to previous anticonvulsants (always including valproic acid) in 10 patients aged 23–44 years, with intractable absence and generalized tonic–clonic seizures. Seven patients became seizure free, three patients had > 75% reduction in seizure frequency. The patients have remained on comedication with valproic acid and lamotrigine, after gradually discontinuing most other anticonvulsants, for a follow-up period ranging from 1–4 years. There has been no increase in seizure frequency during this period. None of the patients reported any side effects. This study supports the growing evidence of therapeutic synergy between lamotrigine and valproic acid. This combination may be the therapy of choice for refractory absence and generalized tonic–clonic seizures both in children and adults.