Wednesday, June 17, 2015

The use of lacosamide in partial epilepsy: Does it work and is it harmful?

Cochrane: Lacosamide is an antiepileptic drug that can be added along with others to treat people who have certain types of epileptic seizures. This drug may be beneficial for people who are taking other antiepileptic medication but continue to have seizures. This review looked at how well lacosamide works when added to a patient's daily medication and also looked at some of the harms or side effects of the drug.

To be included in this review, all participants had to be adults with a diagnosis of epilepsy, specifically having partial seizures. Patients were required to have been already taking at least two other antiepileptic medications that were not currently working to reduce seizures.

Review authors found that lacosamide reduced the frequency of seizures. The added antiepileptic drug was over one and a half times better at reducing seizures than placebo. The higher the dose of lacosamide, the better it was at reducing the number of seizures. Also patients who took lacosamide were more likely to have no seizures at all than those who took the placebo, but they were more likely to withdraw from lacosamide largely because of side effects. Side effects included blurred or double vision, problems with co-ordination and feelings of dizziness and nausea.

Altogether the three trials were judged to use good methods, and so the evidence in this review was rated as high in quality. More research is needed to look at the long-term effects of lacosamide and to explore how well it works in children with epilepsy.
Authors' conclusions: 

This review has shown lacosamide to be effective and fairly well tolerated in the short term when used as add-on treatment for drug-resistant partial epilepsy in adults. Higher doses of lacosamide may be more associated with adverse effects and withdrawal of the drug than lower doses. Additional evidence on children is needed, and longer-term efficacy is unknown.