title: Cognitive effects of lacosamide as adjunctive therapy in refractory epilepsy.
abstract: BACKGROUND
  Lacosamide (LCM) is a novel antiepileptic drug (AED) with potential benefit as adjunctive treatment in patients with partial-onset seizures. As yet, limited information on cognitive effects of LCM is available, especially in real-life settings.
  
  
  OBJECTIVE
  In this open clinical prospective study, the cognitive effects of LCM were evaluated when used as adjunctive antiepileptic therapy in patients with refractory epilepsy.
  
  
  METHODS
  We included 33 patients aged between 16 and 74 years (mean: 37 years). All patients had a localization-related epilepsy. Patients were assessed at baseline before starting LCM treatment and during follow-up when the optimal clinical dose was achieved.
  
  
  METHODS
  Subjective complaints were evaluated using the SIDAED; effects on cognition were evaluated using the computerized visual searching task (CVST).
  
  
  RESULTS
  The CVST showed significant faster information processing reaction times at the second evaluation (P = 0.013), which was not correlated with seizure control, type of epilepsy, age, gender, drug load, number of concomitant drugs, dose or duration of LCM treatment. On the SIDAED, patients complained more about their cognitive function at the second evaluation (P = 0.005). For the SIDAED, a positive correlation at follow-up was found between the total severity score and higher age (r = 0.375, P = 0.031), but not with epilepsy factors or treatment characteristics.
  Screening of the cognitive effects of LCM showed that LCM does not have negative effects on information processing speed. As this is the most sensitive function for cognitive side effects of AEDs, LCM does not seem to induce the common negative cognitive effects. Remarkably, patients complained more, especially about their cognitive function, which is possible the 'doing better, feeling worse phenomenon'.
authors: Departments of Neurology and Neuropsychology Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
authors: D M
authors: DM
authors: IJff
authors: T M
authors: TM
authors: van Veenendaal
authors: H J M
authors: HJ
authors: Majoie
authors: A J A
authors: AJ
authors: de Louw
authors: J F A
authors: JF
authors: Jansen
authors: A P
authors: AP
authors: Aldenkamp
mesh_terms: D000081:Acetamides / Q000009:adverse effects* / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects*; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000078334:Lacosamide; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000081:Acetamides; D000927:Anticonvulsants; D000078334:Lacosamide
keywords: adverse effects; anti-epileptic drug; cognition; epilepsy