Flexible Doses Help With Epilepsy Drug

Fewer Side Effects Reported With Flexible Doses of Antiseizure Drug Lyrica

Medically Reviewed by Ann Edmundson, MD, PhD on December 29, 2005
From the WebMD Archives

Dec. 29, 2005 -- "One size fits all" may not be the rule of thumb for doses of epilepsy drugs.

A new study shows fewer side effects in epileptic adults taking flexible doses of the antiseizure drug Lyrica, compared to those taking a fixed daily dose of the drug.

Lyrica is used as a second-line drug treatment for patients with epilepsy. The drug is similar in structure to the frequently used drug, Neurontin (gabapentin).

Flexible doses of Lyrica may signal a "treatment advantage" the researchers write. They note that doctors often adjust Lyrica doses to each patient.

The study, published in Epilepsia, comes from doctors including Christian Elger, MD, PhD, FRCP, of Germany's University of Bonn.

The study included 341 adults with epilepsy who had partial seizures.

About Epilepsy

A person is diagnosed with epilepsy when they have two or more seizure episodes because many people only have one seizure episode in their lifetime.

Partial seizures occur when only a specific area of the brain has an electrical disturbance; generalized seizures involve multiple areas in the brain.

For example, a person with a partial seizure may have uncontrolled repetitive movements of the tongue. Partial seizures can involve not only movements, but also a specific emotion or sensation.

Sometimes a partial seizure can spread to other parts of the body and the person may even lose consciousness and have a generalized seizure.

Fixed vs. Flexible

The patients included in this study had failed to have control of their epilepsy with one epilepsy drug and were on several epilepsy drugs.

The patients were split into three treatment groups:

  • Twice daily flexible doses of Lyrica totaling 150-600 daily milligrams per day
  • Twice daily fixed doses of Lyrica totaling 600 milligrams per day
  • Twice daily fake drug (placebo)

Patients kept journals of their seizures throughout the 12-week study.

Both Lyrica doses were better at reducing seizures than the placebo. The fixed doses were "superior," write the researchers, at reducing seizures.

But, that wasn't the only important finding.

Fewer Side Effects With Flexible Doses

The fixed and flexible doses were both "generally well-tolerated," the researchers write.

However, patients taking the flexible doses reported fewer side effects. They were also more likely to finish the study than those taking the fixed doses.

More than three quarters of the 131 patients taking the flexible doses completed the study (76%) compared to 58% of the 137 patients assigned to the fixed doses.

The most commonly reported adverse events were mild to moderate dizziness, weight gain, sleepiness, problems with muscle coordination (ataxia), and fatigue.

Three of the researchers who worked with Elger on this study are employees of Pfizer, Lyrica's maker. Pfizer is a WebMD sponsor.

Show Sources

SOURCES: Elger, C. Epilepsia, December 2005; vol 46: pp 1926-1936. News release, Blackwell Publishing Ltd.
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