Abstracts

Rationale: We sought to determine the effectiveness of the newly-marketed antiepileptic drug (AED), lacosamide, in adult epilepsy patients. Methods: The outcomes of adult epilepsy patients who were prescribed lacosamide for additional seizure control are presented herein. The data was compiled by chart review. Responders were defined as having at least a 50% decrease of seizure frequency of all seizures types combined. Seizure types evaluated were complex partial, generalized tonic clonic and atonic. Statistics used were descriptive and Spearman s rank correlations (2-tailed). Results: Sixty seven patients were evaluated; ages ranged from 18-82, mean 38; 35 were women (52%); mean duration of epilepsy 24 years (range 1-54); mean age of onset 14 years. The patients were refractory having tried up to 16 medications each and VNS with a (mean of 8). The seizure types evaluated were complex partial, 61 patients(91%), generalized tonic clonic, 24 patients (36 %) and atonic, 11 patients (16 %). Lacosamide dose ranges were 50mg - 600 mg per day (278 mg mean dose). The mean duration of treatment was 7 months, range 1-12 months. Forty-six out of 67 patients (69%) were responders. The correlation between dose and responder rate approached significance at 0.093. Twenty-two patients (33%) reported no seizures in the most recent treatment month; this included the only two patients on lacosamide monotherapy. There was no difference in lacosamide dose between patients taking or not taking sodium-channel acting AEDs. Forty two of sixty nine complex/partial (69%), eighteen of twenty four patients with generalized tonic/clonic (75%) and twelve of fourteen patients with atonic seizures((86%) were responders. Fourteen patients (21%) discontinued; 5 due to side effects (2 for dizziness and 3 for rash), 4 for lack of efficacy and 5 for both. The most frequent side effect was dizziness and discoordination in 22 (33 %) patients, while 10 patients had psychiatric side effects (15 % with mood and anxiety complaints), 2 had headaches (3%) and 3 (4 %) had possible allergic rash. 9 patients (13 %) required dose adjustments secondary to negative side effects. Conclusions: Our initial results with lacosamide indicate a high responder rate. A higher responder rate was present in those patients who were not taking sodium channel-acting drugs. Allergic rash occurred in 4%.