Lamotrigine needs to be tapered gradually, without seizures and its potential to increase seizures, and finally discontinued.
As one of the new antiepileptic drugs commonly used in clinical practice, lamotrigine is suitable for primary, simple and complex partial seizures and secondary generalized tonic clonic seizures. The steps of lamotrigine discontinuation are divided into two steps: drug reduction and discontinuation, which need to be reasonably timed.
1. Dose reduction: the first step in the discontinuation of lamotrigine is to reduce the dose. If the seizures are seizure-free after 3-5 years of control, a dose reduction can be considered, starting with a reduction of 1/8-1/4 of the dose. The dosage adjustment process will take more than 2 weeks (about 50% per week), and the smaller the dose, the safer the dose is, unless the safety considerations require a quicker discontinuation of the medication.
2. Discontinuation: If the patient’s general condition is good during the dose reduction process, and no seizures have occurred after complete dose reduction, and the EEG or neurologist’s assessment has been completely normalized, the medication can be discontinued.
If seizures occur during the above two processes, then it means that the drug reduction has failed, and the drug reduction needs to be stopped immediately and the patient should go to the hospital in time.