Han Seung-A, Yang Eu Jeen, Song Mi-Kyoung, Kim Sun Jun
Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.
Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.
Korean J Pediatr. 2017 Jun;60(6):189-195. doi: 10.3345/kjp.2017.60.6.189. Epub 2017 Jun 22.
The purpose of this study was to investigate the effects of lamotrigine for the treatment of attention-deficit hyperactivity disorder (ADHD) symptoms in children with epilepsy.
Pediatric patients newly diagnosed with epilepsy (n=90 [61 boys and 29 girls]; mean age, 9.1±3.4 years) were enrolled. All patients were evaluated with the Korean ADHD rating scale (K-ARS)-IV before treatment with lamotrigine and after doses had been administered. The mean interval of ADHD testing was approximately 12.3 months. The initial dosage of lamotrigine was 1 mg/kg/day (maximum 25 mg/day for the first 2 weeks), and increased by 1 mg/kg every 2 weeks until titrated up to 7 mg/kg/day (or maximum 200 mg/day).
The mean ADHD test score of the 90 subjects was 17.0±1.8 at baseline. It was slightly reduced to 15.6±1.7 after lamotrigine monotherapy ( >0.01). Prior to treatment, a total of 31 patients (34.4%) met the diagnostic criteria for ADHD according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, Of these 31 patients, 27 (87.1%) had significantly improved ADHD scores with lamotrigine monotherapy (28.0±1.6 reduced to 18.1±2.6, <0.001). Among these 27 patients, 25 (92.6%) showed normalized electroencephalogram (EEG) and 26 (96.3%) achieved total freedom from seizures within 12 months of the initiation of lamotrigine monotherapy.
The results from our study show that lamotrigine had a positive effect in pediatric epilepsy patients by reducing ADHD symptoms, preventing seizures, and normalizing EEG. However, further research is required to determine whether lamotrigine is efficacious against ADHD symptoms independent of its effects on epileptic seizures.
本研究旨在调查拉莫三嗪对癫痫患儿注意力缺陷多动障碍（ADHD）症状的治疗效果。
纳入新诊断为癫痫的儿科患者（n = 90[61名男孩和29名女孩]；平均年龄9.1±3.4岁）。所有患者在使用拉莫三嗪治疗前和给药后均采用韩国ADHD评定量表（K - ARS）-IV进行评估。ADHD测试的平均间隔时间约为12.3个月。拉莫三嗪的初始剂量为1mg/kg/天（前2周最大剂量为25mg/天），每2周增加1mg/kg，直至滴定至7mg/kg/天（或最大200mg/天）。
90名受试者的ADHD测试平均得分在基线时为17.0±1.8。拉莫三嗪单药治疗后略有降低至15.6±1.7（>0.01）。治疗前，根据《精神障碍诊断与统计手册》第4版，修订版，共有31名患者（34.4%）符合ADHD诊断标准。在这31名患者中，27名（87.1%）使用拉莫三嗪单药治疗后ADHD得分有显著改善（从28.0±1.6降至18.1±2.6，<0.001）。在这27名患者中，25名（92.6%）脑电图（EEG）恢复正常，26名（96.3%）在开始拉莫三嗪单药治疗后12个月内实现完全无癫痫发作。
我们的研究结果表明，拉莫三嗪通过减轻ADHD症状、预防癫痫发作和使EEG恢复正常，对儿科癫痫患者有积极作用。然而，需要进一步研究以确定拉莫三嗪对ADHD症状的疗效是否独立于其对癫痫发作的影响。
