Abstracts

Rationale: In august 2008 Lacosamide (LCM) was approved by the European Medicines Agency (EMEA) as adjunctive therapy for adults with partial epilepsies. We want to report our first clinical experiences in an epilepsy center. Methods: 86 consecutive adult patients (19-72 years old, mean 46 years; 53 female, 33 male) with pharmacoresistant epilepsies (58 partial, 19 multiregional/symptomatic generalized epilepsy, 9 not classified) were treated with LCM (middle dosis 300mg) as an add on-drug between 9/08 and 5/09. The mean follow up (outpatient based) was 4 months (2-8 months). Results: 7 patients had to be excluded from analysis due to short follow up (< 2 months), 36/79 pats. (45,6%) responded (reduction of total seizure frequency > 50%), 33/79 pats. (41,8%) were non-responder. In 10/86 pats. (11,6%) treatment had to be discontinued (severe increase of seizure frequency in 3 pats., psychosis in 1 pat., pregnancy 1 pat., other side effects in 5 pats). In 23 pats. dose-dependent side effects occurred (toxic cerebellar syndrome, drowsiness), which could be eliminated by reduction of the comedication (mostly sodium-channel blockers: CBZ, OXC, OXC). Conclusions: Our first results confirm data of previous trials. LCM is effective in pharmacoresistant epilepsy and mostly well tolerated. Further investigations have to evaluate the efficacy in specific epilepsy syndromes and the spectrum of side effects.