Lacosamide monotherapy for patients with epilepsy and comorbid psychiatric disorders: A retrospective chart review

Epilepsy is a prevalent neurological disorder frequently accompanied by psychiatric comorbidities such as depression and anxiety, which can substantially affect patients' quality of life. Lacosamide (LCM), a novel anti-seizure medication, exhibits a favorable safety profile, particularly in individuals with psychiatric conditions. However, a complex relationship exists between epilepsy and psychiatric symptoms, and the effects of LCM monotherapy on patients remain unclear. This study aimed to evaluate the efficacy and tolerability of LCM monotherapy over a 6-month observation period in patients with epilepsy (PWE) with and without psychiatric disorders. This study retrospectively analyzed the effects of LCM monotherapy on seizure control and psychiatric symptoms in 55 adult PWE at a specialized epilepsy center in Japan. Participants were categorized into two groups: those with (n = 19) and those without psychiatric disorders (n = 36). More than 80% of the participants in both groups achieved seizure freedom. The incidence of psychiatric adverse effects was only one case of irritability, suggesting that LCM is well tolerated even in patients with pre-existing psychiatric conditions. Two patients with anxiety disorders experienced symptom improvement after LCM treatment. These results suggest that LCM monotherapy may be a well-tolerated option for PWE, including those with psychiatric comorbidities, as it was not associated with significant worsening of psychiatric symptoms during the study period.