A recent University of Washington report, published in the journal of the American Academy of Neurology, found a combination of two common drugs, lamotrigine and valproate, is more effective in treating refractory epilepsy than other anti-epileptic regimens.
In a large-scale retrospective study of patients with very difficult-to-control epilepsy, researchers discovered that out of the 32 drug combinations studied, only the lamotrigine/valproate treatment regimen significantly decreased seizure frequency in this group. This specific combination reduced seizure frequency by about half, on average, compared to other regimens.
Although it rarely produced complete freedom from seizures, the combination was better than others in reducing the number of convulsive seizures patients experienced.
Not all drug treatments are equally ineffective for this patient population,” said Dr. Nicholas P. Poolos, head of the research team. “And it provides evidence for future, prospective drug trials.”
“Identifying any anti-epileptic drug regimen with superior efficacy in patients with refractory epilepsy would be a substantial advance,” the researchers believed.
Additionally, researchers were surprised to find that while concurrent use of two anti-epileptic drugs was more effective than a single drug alone, three drugs at a time offered no additional benefits. Limiting the combination to two may lessen side effects from taking more kinds of anti-epileptic drugs, without sacrificing efficacy.
The Chair of the Epilepsy Foundation’s Professional Advisory Board, Joe Sirven, says, “This is an important study because it is the first such study to suggest that a single combination of medications is better than any single one drug choice.
Given that there are more than 20 medications approved for epilepsy in the US, the concept of a combination of specific medications being better than any single one drug for an epilepsy subtype would be significant.
It would offer the hope that certain combinations of drugs may be best for given patients.
This is important and would definitely change practice of epilepsy. The reason for that change is that the emphasis would shift from drugs that are the magic bullet working alone to looking for drugs in combination. That is a paradigm shift in epilepsy.”