Maryek G. The differential therapy basis of the refractory epilepsy in psychiatric practice.

The dissertation is devoted to the problem of differential therapy basis of the refractory epilepsy with phenyltriazine anticonvulsant (lamictal) using. Lamictal has wide range anticonvulsive effect: efficacy for refractory primary generalized epilepsy as monotherapy 80% and as add-on therapy - 42,1% (p>0,05). As add-on therapy lamictal is more effective with valproic acid than with enzyminduced antiepileptic drugs (60% versus 22,2%, p>0,05). As monotherapy of the refractory partial epilepsy lamictal is more effective than add-on therapy to (81,8% versus 52,3%, p<0,05) but without difference for the types of basic therapy. For the first time it is ascertain the higher effectiveness of lamictal in treatment sleep epilepsy. Generally lamictal using is effective in 50% patients with primary generalized and 56,5% patients with partial epilepsy. It is studied that lamictal has its own psychotropic cerebroprotective effect including psychoactive, nootrop and mnemotrop activity with mood stabilization activity. Based on the data of the adverse events it is proposed to use more moderate lamictal dosage chart add-on therapy with the enzymes induce antiepileptic drugs. It is necessary to take into consideration of valproic acid dose before lamictal treatment for combined therapy to (it must be not higher than 20 mg/kg).