Indications: epilepsy; monotherapy and adjunctive treatment of partial seizures and tonic clonic seizures not satisfactorily controlled with other antiepileptic drugs.

Cautions: closely monitor and consider withdrawal if rash, fever, or other signs of hypersensitivity syndrome develop; abrupt withdrawal may provoke rebound seizures; impaired renal and hepatic functions; pregnancy and breast-feeding.

Contra-indications: hypersensitivity reactions. symptoms and signs suggestive of bone-marrow failure such as anaemia, bruising, or infection.

Side Effects: skin rashes that may lead to withdrawal of the drug; Stevens-Johnson syndrome; diplopia, blurred vision, nystagmus, dizziness, drowsiness, headache, unsteadiness, tiredness, hallucinations, occasional increase in seizure frequency; gastrointestinal disturbances, and irritability/aggression; blood disorders (including leucopenia, thrombocytopenia, pancytopenia); arthralgia; lupus erythematosus-like effect; photosensitivity.

Dose: the dispersible tablets may be chewed, dispersed in a small volume of water or swallowed whole with a little water.

Monotherapy, ADULT and CHILD over 12 years, initially 25 mg daily for 14 days, increased to 50 mg daily for further 14 days, then increased by max. 50–100 mg daily every 7–14 days; usual maintenance 100–200 mg daily in 1–2 divided doses (up to 500 mg daily has been required) Adjunctive therapy with valproate, initially 25 mg every other day for 14 days then 25 mg daily for further 14 days, thereafter increased by max. 25–50 mg daily every 7–14 days; usual maintenance, 100–200 mg daily in 1–2 divided doses; CHILD 2–12 years initially 150 mcg/kg daily for 14 days (those weighing under 13 kg may receive 2 mg on alternate days for first 14 days) then 300 mcg/kg daily for further 14 days, thereafter increased by max. 300 mcg/kg daily every 7–14 days; usual maintenance 1–5 mg/kg daily in 1–2 divided doses.