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Child has seizure. What should be the dosage of lamitrogine?

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General & Family Physician
Practicing since : 2004
Answered : 1775 Questions
lamitrogine dosage my daughter is taking valporic acid 200 twice a day and 50mg lamotrigine in the night. she was ok for 1.5 month wo any seizure. today morning she got a seizure again. it was gran mal. she is going to be 9 yrs next month. body weight 26kg. is the dosage ok? should i increase the lamitrogine?
started lamotrigine with.25mg in april 2012. gradually increased to 50mg in Aug 2012. till this time she had 3 grand mal ( from April to Aug )
Posted Fri, 26 Oct 2012 in Brain and Spine
Answered by Dr. Chakravarthy Mazumdar 34 minutes later

I understand your concern. This is extremely sensitive question to answer on this forum. Although there are set guidelines and treatment protocols any child requires a tailor made treatment. A physician starts an epileptic with lowest possible dose and timely verify the clinical condition to increase / decrease it. The dosage of lamotrigine varies a lot from child to child especially when the child is already on Valproate. The dose differs whether it is Xtended release(XR) or oral dis integration or chewable forms.

The dose that your child receives now is standard (I guess it is XR) and I do not think it is appropriate to comment any more about dose without actuals of the medical history and examination. The doctor critically assess the condition and takes the decision in the favor of your child's benefit. Believe me all these anti epileptics have very narrow safety spectrum. A higher dose or a lower dose both can induce grand mal seizures.

Finally if the clinician is unable to control the seizures it is appropriate to take a second opinion from different Pediatric Epilepsologist about the course of treatment rather than the dose of it.

Hope I could throw some light on it and make you understand the sensitive nature of the such questions on this educational forum.

Above answer was peer-reviewed by
Follow-up: Child has seizure. What should be the dosage of lamitrogine? 17 minutes later
what is the maximum lamotrigine for a child of 26kg body weight. ? is 50mg high or low
Answered by Dr. Chakravarthy Mazumdar 10 minutes later
As standard recommendations are 1-3mg/kg/day along with valproic acid, there seems to be a room for increase in the dose if the seizures are uncontrolled. There is a thought to increase up to 50% as maintainance. Since your child is still receiving the therapeutic dose let the doctor decide to increase it.

Please remember not to take any decision without consulting your treating doctor.

Thank you.
Above answer was peer-reviewed by
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