In this paper we make an extensive review of the most recent and important studies which have been published on lamotrigine, a phenyltriazinic compound unrelated to the other known anti epileptic drugs, which is available on the market in many countries and is currently considered to be a first line anti epileptic drug. It is known that its anti epileptic effect is mainly due to blocking the voltage sensitive sodium channels most effectively in depolarized cells, resulting in the presynaptic inhibition of excessive release of excitatory amino acids, particularly glutamate and aspartate. In this review, we fully discuss their different mechanisms of action and compare various experimental animal studies with the use of these drugs in humans and the results obtained in everyday clinical practice. Amongst the metabolic aspects we analyze the reasons why children are more prone to develop enzyme induction than adults are. It has been shown that in infancy patients who take inductors and inhibitors show figures for the half life of lamotrigine which are between those of patients who take inductors only and those taking inhibitors only, causing a so called mixed effect . Adverse effects include skin eruptions which may lead to withdrawal of the drug. However, it should be remembered that the proportion of persons with this side effect is much reduced when the correct dosage is used, and the sliding scale of dosage starts with sufficiently low doses. After extensive analysis of the results, we point out the new possibilities now available for the treatment of other disorders besides epilepsy. We show the positive aspects of this treatment, its use in epileptic seizures and interactions in disorders besides epilepsy now that the mechanism of action is better understood.
PMID: 12373658 [Pubmed - MEDLINE]