LTG may be a good option for patients with poorly controlled epilepsy due to treatment-limiting side effects, and those with a history of drug intolerance but adequate seizure control, but skin reactions are common and may be serious. The authors conclude that, as LTG as add-on therapy is significantly better than placebo at reducing frequency of seizures, they support its use. They offer only limited support for the use of LTG as monotherapy, as it is only as effective as established drugs in the medium term treatment of partial and generalised epilepsy in adults, but is more expensive. They add that, with no significant difference in efficacy, enhanced safety and tolerance are of critical importance in differentiating between alternative treatments, as is cost minimisation. LTG may be better tolerated than established drugs.
