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Lamotrigine is a phenyltriazine-based compound effective in the treatment of partial and generalized seizures (Table 15-1).1,2,3, and 4 Although lamotrigine is listed as a recommended therapy for absence seizures by expert panels, recent literature suggests that ethosuximide or valproic acid may be more effective initial therapy for this epilepsy type.5,6 It is also useful for the treatment of bipolar disorders, neurogenic pain, and Lennox-Gastaut syndrome.7,8, and 9 While lamotrigine was originally developed as a antifolate agent, its therapeutic effects are not related to this property. The proposed mechanism of action in humans is the inhibition of voltage-sensitive sodium channels, which stabilizes neuronal membranes and modulates the presynaptic transmitter release of glutamate and aspartate.9,10,11, and 12

TABLE 15-1International Classification of Epileptic Seizures With Recommended Therapies

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