ABSTRACT

Lacosamide (LCM) is a new generation amino acid drug that is used in patients with drug-resistant epilepsy, which increases the slow inactivation of voltage-dependent sodium channels. In this study, the short-term results of patients with drug-resistant epilepsy who received add-on LCM therapy were evaluated.

Patients who were at least 16 years old and had focal onset seizures for a minimum period of 1 year were retrospectively assessed. Those who had uncontrolled seizures, despite the use of two appropriate antiepileptic drugs at an effective dose for at least six months, were included in the study. Forty-five eligible patients (11 females, 34 males) underwent further analysis. LCM therapy doses, change in seizure frequency, number of seizures before and after LCM therapy, and the effect of LCM add-on therapy on seizures were analyzed.

The mean age of the included 45 patients (11 females, 34 males) was 31.42 (16–56) years. Twenty-six of 45 (57.8%) patients under add-on therapy showed a decrease of 50% or more. It was observed that the seizure frequency decreased to a median of 2 (IQR: 0.5–5), which was statistically significant (p<0.001). The dose was not correlated with the seizure decrease ratio (p=0.216). The decrease in seizure frequency was similar in patients with LCM add-on treatment as the second or third drug, when compared with patients using LCM as the fourth or fifth drug (p=0.231).

It was observed that LCM add-on therapy significantly decreased seizure frequency, similar to the current literature. On the contrary, the dose effect or earlier add-on therapy did not show a significant effect on seizure frequency. LCM should be considered as a successful treatment option in patients with drug-resistant focal onset seizures.

Keywords: Add-on therapy, antiepileptic drugs, drug-resistant epilepsy, lacosamide, polytheraphy