Lacosamide for the treatment of epilepsy.
BACKGROUND
Epilepsy is one of the most common neurological disorders. Despite the development of new antiepileptic drugs (AEDs), ∼ 30% of epilepsy patients experience recurrent seizures and even more experience side effects. Therefore, there is still need for new AEDs with enhanced effectiveness and tolerability.


METHODS
The article is based on a search using PubMed, including articles published between 1999 and 2013. It is focused on the pharmacokinetic, pharmacological and clinical data of lacosamide (LCM) for the treatment of epilepsy.


CONCLUSIONS
Along with favorable tolerability and pharmacokinetic profiles, LCM has been demonstrated to significantly reduce seizure frequency in patients with partial-onset seizures when prescribed as adjunctive treatment at doses of 200 and 400 mg/day. LCM has a unique mechanism of action, selectively enhancing slow inactivation of voltage-gated sodium channels. Its mechanism of action could be exploited to reduce the percentage of pharmacoresistant patients. Although LCM is not FDA approved for treatment of status epilepticus, it has demonstrated promising preliminary results. Large prospective studies are needed to verify these. In addition, the results of ongoing trials will help to confirm if LCM could be used as a monotherapy regimen in the treatment of partial-onset seizures and generalized tonic-clonic seizures.
University of Udine Medical School, Department of Experimental and Clinical Medical Sciences, Neurology Unit , Piazza Santa Maria della Misercordia, 15 33100 Udine , Italy.
Stefano
S
de Biase
Gian Luigi
GL
Gigli
Mariarosaria
M
Valente
Giovanni
G
Merlino
D000081:Acetamides / Q000737:chemistry / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000737:chemistry / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D004353:Drug Evaluation, Preclinical; D004347:Drug Interactions; D004827:Epilepsy / Q000188:drug therapy*; D006801:Humans; D000078334:Lacosamide; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000081:Acetamides; D000927:Anticonvulsants; D000078334:Lacosamide