Lamotrigine and mexiletine show similar benefits in nondystrophic myotonias

WEDNESDAY, Oct. 9, 2024 (HealthDay News) — Improvements in nondystrophic myotonia symptoms are similar for lamotrigine and mexiletine, according to a study published in the October issue of The Lancet Neurology.

Vinojini Vivekanandam, Ph.D., of the Center for Neuromuscular Disorders at the National Hospital for Neurology and Neurosurgery in London, and colleagues randomly assigned 53 adults with genetically confirmed symptomatic nondystrophic myotonia to either mexiletine for eight weeks and then lamotrigine for eight weeks or lamotrigine followed by mexiletine with a seven-day washout period in between.

The researchers found that the mean interactive vocal response stiffness score after treatment with mexiletine was 2.54 versus 2.77 with lamotrigine (mean mexiletine-lamotrigine difference -0.23; 95 percent confidence interval -0.63 to 0.17 ). In both groups, the most common side effect was indigestion/reflux (eight participants, 208 participant days received mexiletine; seven participants, 130 participant days received lamotrigine). There were no serious adverse events.

“Around one in 17 people in the UK suffer from a rare disease and the majority do not receive treatment. Many are neurological diseases and their rarity makes clinical trials to develop treatments very difficult,” Vivekanandam said in a statement. “The study results are very exciting and important for patients with this muscle channelopathy.”

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