Adjunctive lacosamide--5 years' clinical experience.

Area of Science:

• Neurology
• Pharmacology

Background:

• Lacosamide (LCM) was approved in Europe in 2008 for adjunctive treatment of focal-onset seizures.
• A prospective audit was conducted to evaluate LCM's effectiveness in clinical practice.

Purpose of the Study:

• To assess the outcomes of lacosamide (LCM) as an adjunctive treatment for focal-onset seizures in everyday clinical practice.
• To evaluate the efficacy and tolerability of LCM in a real-world setting.

Main Methods:

• 160 patients with uncontrolled focal-onset seizures were initiated on LCM.
• Patients received LCM as an add-on therapy, with doses titrated to 200-400 mg/day.
• Outcomes were assessed over 6 months, measuring seizure freedom, seizure reduction (≥50% or <50%), or treatment withdrawal.

Main Results:

• 21.9% of patients achieved seizure freedom for at least 6 months.
• An additional 21.9% were responders (≥50% seizure reduction), and 33.7% showed marginal benefit.
• LCM was discontinued in 22.5% of patients due to lack of efficacy (15%) or side effects (7.5%).

Conclusions:

• Lacosamide is a well-tolerated and effective antiepileptic drug for focal-onset seizures.
• Treatment outcomes were consistent regardless of concomitant antiepileptic drugs.
• Common dose-related side effects were neurotoxic, including nausea, vomiting, dizziness, sedation, headaches, tremor, and ataxia.