Epilepsy Talk

For Refractory Epilepsy — Two AEDs and You’re Home Free! | January 8, 2012

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.”









  1. When Valporate was first out it controlled my seizures for a whole year! I had 2 brain surgeries. I am on Keppra 6000 mg a day. I am ready for a change! To try it! I take zonegran too and klonopin. I feel like throwing it out the window but it does help in a manner of speaking.

    I would be will to try it. Thanks for the info.


    Comment by Toni — January 8, 2012 @ 11:43 PM

  2. Have you tried Lamictal? I take Lamictal and Klonopin and it works like dream for me.


    Comment by Phylis Feiner Johnson — January 9, 2012 @ 12:20 AM

  3. That may be my next plan to try Lamictal again. I cannot remember why I got off it.

    I liked the gen’l info on drugs given at epilepsy.com via the head, too.



    Comment by Toni — January 9, 2012 @ 2:49 AM

    • Toni, I was on Facebook & a member claimed a GP took her Off Lamictal becuz he heard it was addictive. Sad! Cuz, the Lamictal Was controlling her seizures. 😦 She isn’t seeing a Neuro. Can’t afford it. 😦 And the New med the GP placed her on isn’t working. I shared some of epilepsytalk articles w/ her. I do Hope she read them. 😦

      Hope you have a Good Day. HUGS!


      Comment by candi — January 11, 2012 @ 2:25 PM

  4. RE: Lamictal: Did you get Stevens-Johnson rash?

    Epilepsy.com is a terrific resource. It’s my second favorite website. 😉


    Comment by Phylis Feiner Johnson — January 9, 2012 @ 3:10 PM

  5. […] find out more, click on: https://epilepsytalk.com/2012/01/08/for-refractory-epilepsy-two-aeds-and-youre-home-free/ Share this:TwitterFacebookLinkedInLike this:LikeBe the first to like […]


    Pingback by For Refractory Epilepsy — Two AEDs and You’re Home Free! « epilepsyconnection — July 21, 2012 @ 5:31 PM

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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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