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.