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Seizure. 2015 Nov;32:75-7. doi: 10.1016/j.seizure.2015.09.007. Epub 2015 Sep 21.

Concomitant lamotrigine use is associated with decreased efficacy of the ketogenic diet in childhood refractory epilepsy.

Author information

1
Department of Dietetics, Erasmus University Hospital Sophia Children's Hospital, Rotterdam, The Netherlands. Electronic address: e.vanderlouw@erasmusmc.nl.
2
Department of Child Neurology, Erasmus University Hospital Sophia Children's Hospital, Rotterdam, The Netherlands.
3
Department of Hospital Pharmacy, Erasmus University Hospital Sophia Children's Hospital, Rotterdam, The Netherlands.

Abstract

PURPOSE:

Anti-epileptic drugs (AEDs) and the ketogenic diet (KD) are often used concomitantly in children with refractory epilepsy. It has been hypothesised that certain AEDs may interfere with KD. The purpose of this study was to elucidate relationships between efficacy of KD and use of specific AEDs.

METHODS:

A retrospective study was performed in 71 children with refractory epilepsy starting the KD between 2008 and 2014 in Erasmus University Hospital Sophia Children's Hospital. Efficacy of the KD (defined as 50% seizure reduction) was evaluated after three months of treatment and related to the AEDs used.

RESULTS:

The KD was successful after three months in 61% of the children (N=71). Efficacy was significantly reduced if children (n=16) used lamotrigine (31%) at diet initiation or in the course of the diet, compared to other antiepileptic drugs (69%) (p=0.006). In comparison to children using other antiepileptic drugs, the percentage of children that had adequate ketosis was significantly reduced in case of lamotrigine use (p=0.049).

CONCLUSION:

Lamotrigine treatment during KD is associated with a decreased efficacy of the KD.

KEYWORDS:

Antiepileptic drugs; Children; Efficacy; Epilepsy; Ketogenic diet; Lamotrigine

PMID:
26552568
DOI:
10.1016/j.seizure.2015.09.007
[Indexed for MEDLINE]
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