Clinical experience with oral lacosamide as adjunctive therapy in adult patients with uncontrolled epilepsy: A multicentre study in epilepsy clinics in the United Kingdom (UK)

INTRODUCTION Lacosamide (LCS) is a new antiepileptic drug (AED) licensed in the European Union (EU) and United States (US) in 2008. AIMS To evaluate the efficacy and tolerability of add-on LCS in an out-patient epilepsy clinic setting to obtain useful information for everyday practice. METHODS We pooled data retrospectively from the case note of patients with refractory epilepsy in whom LCS had been prescribed in 19 hospitals across the United Kingdom. RESULTS Four hundred and three patients were included (mean age 41.9 years, 50.6% women, 18.1% with learning disabilities (LD)). Mean follow-up (FU) was 11.6 months (range one day to 42 months). Most patients (86.9%) presented with symptomatic partial epilepsy (SPE) and 80% were taking two or more antiepileptic drugs (AEDs) when LCS was added (mean 2, range 0-4). Retention rates were 80% at six months, 68% at one year and 45% at two years. The efficacy of LCS was evaluated at three months and at the final FU. At three months one hundred and eight patients (31.1%) reported ≥ 50% seizure reduction and 32 (9.2%) were seizure free. At the final FU 102 (37.5%) reported ≥ 50% seizures reduction and 28 (9.8%) were seizure free. One hundred and ninety three patients (48.7%) reported adverse effects (AEs). The most frequent were sedation and dizziness, followed by nausea. Lacosamide was discontinued in 150 patients (38%), 60 due to AEs alone. CONCLUSION LCS appears to be an effective and safe AED when used as adjunctive therapy in patients with refractory partial epilepsy.