拉莫三嗪。综述其药理特性及治疗癫痫的临床疗效。

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Goa KL, Ross SR, Chrisp P

拉莫三嗪。综述其药理特性及治疗癫痫的临床疗效。

药物。1993七月;46(1):152-76。doi: 10.2165 / 00003495-199346010-00009。

PubMed ID

7691504 (PubMed视图

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摘要

拉莫三嗪是一种抗癫痫药物，被认为是通过抑制兴奋性神经递质的释放来抑制癫痫发作。疗效已证明拉莫三嗪作为现有方案的附加治疗患者的抵抗性部分癫痫。与安慰剂相比，总癫痫发作频率降低了17 - 59%，13 - 67%的患者癫痫发作频率降低了>或= 50%。拉莫三嗪对继发性全身性强直阵挛发作反应良好，初步证据表明，对原发性全身性癫痫、lenox - gastaut综合征患者和多种癫痫发作类型的儿童有改善作用。在停止其他药物治疗后，继续接受拉莫三嗪作为单药治疗的患者癫痫发作得到控制。一项试验的结果表明，拉莫三嗪单药治疗与卡马西平的疗效相似，但其在这种情况下的使用尚需与现有药物进行更广泛的对照比较。拉莫三嗪作为附加治疗相关的不良事件是抗癫痫药物的典型，即头晕、共济失调等中枢神经系统相关症状。在安慰剂对照试验中，10%的患者出现皮疹，可能很严重，1%的患者出现皮疹导致停止治疗。拉莫三嗪长期耐受性良好，但这方面的情况需要进一步监测。丙戊酸和促酶抗癫痫药对拉莫三嗪的影响消除，需要调整拉莫三嗪的剂量。 Conversely, lamotrigine has little apparent influence on the pharmacokinetics of other agents, although it may increase plasma concentrations of the active metabolite of carbamazepine during concomitant administration. Thus, lamotrigine permits improved seizure control in some patients with refractory partial seizures, and may prove to be especially effective in secondarily generalised tonic-clonic seizures. As is usual at this stage in a drug's development, several aspects of the profile of lamotrigine are incompletely defined, notably its efficacy in other seizure types, in children, as monotherapy, and its longer term tolerability. Nonetheless, lamotrigine presently offers a worthwhile alternative for the physician confronted with the challenge of treating patients with intractable partial seizures with or without secondarily generalised seizures, and shows potential for broader applications in other areas of epilepsy management.

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拉莫三嗪