Abstracts

Rationale: Despite the introduction of multiple new antiepileptic drugs (AEDs) in the past 20 years, about 30% of patients with epilepsy continue to experience uncontrolled seizures or significant side effects. This resistance to treatment is even higher in people with mental retardation. In fact, the experience of AEDS in this kind of patients is very low and none of them has been proposed as a good therapeutic option. The aim of this study is to evaluate the efficacy and safety of lacosamide in institutionalized mentally retarded and refractory epileptic patients.Methods: This is a retrospective study and we reviewed the medical charts of all institutionalized mentally retarded and refractory epileptic patients receiving oral lacosamide until May 2013. These patients were classified according the severity of their mental retardation: mild, moderate and severe. All of them were taking other AEDs. Efficacy was determined according the seizure frequency during the month prior to treatment initiation and the month after the maximal dosage. Other demographic data and side effects were also recorded.Results: Seventy seven patients (32 men and 45 women) aged 18-67 (mean 27.8 10.6) years were enrolled. Thirty one patients suffered perinatal anoxia, 17 had epilepsy attributed to a structural cause, 16 had epilepsy of unknown cause, and 13 had Lennox-Gastaut syndrome. The mean number of AEDs they were taking was 2.6 0.6 and the previous AEDs they had tried were 6.6 2.4. The mean follow-up was 6.8 2.6 months. 33% of the patients had at least a 50% seizure reduction, while a small decrease was obtained in another 33%. It was discontinued in 13% of the patients because of inefficacy. Side effects were reported in 12% of the patients. Efficacy and tolerability were similar in all subgroups.Conclusions: Lacosamide seems to be effective and safe in mentally retarded and refractory epileptic patients according to our cohort and these results are independent of the degree of mental retardation of the patients. According to our results, lacosamide could be an important option for these patients.