Neurology

Lamotrigine not linked to increased arrhythmia risk in epilepsy patients

June 20, 2025

Study details: This retrospective cohort study emulated a target trial using U.S. Medicare (n = 40,554) and U.K. Clinical Practice Research Datalink (n = 13,098) data to compare the incidence of ventricular tachycardia/fibrillation (VT/VF) among adults newly treated with lamotrigine vs. levetiracetam for epilepsy.

Results: After adjusting for demographics and comorbidities, lamotrigine was associated with a slightly lower—but not statistically significant—2-year cumulative incidence of VT/VF compared with levetiracetam: Medicare: 1.7% vs 2.3% ; CPRD: 0.2% vs 0.3%. Sensitivity analyses across various populations and arrhythmia definitions yielded consistent findings.

Clinical impact: The findings don’t support concerns about lamotrigine’s proarrhythmic potential and suggest it remains a safe first-line antiseizure option, including for patients with cardiovascular risk factors.

Source:

Terman SW, et al. (2025, July 8). Neurology. Lamotrigine and Cardiac Arrhythmias: A Target Trial Approach. https://pubmed.ncbi.nlm.nih.gov/40499085/