Minimizing pharmacodynamic interactions of high doses of lacosamide

H. B. Edwards, A. G. Cole, A. S. Griffiths, B. Lin, A. Bean, G. L. Krauss

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Objectives- To determine whether pharmacodynamic interactions between high doses of lacosamide (400-800mg/day) and concomitant sodium channel antiepilepsy drugs (AEDs) can be minimized in patients with drug-resistant partial-onset seizures. Materials and methods- Patients were rapidly initiated with high-dose lacosamide (100mg/week; increases to 400 to 800mg/day), while simultaneously tapering concomitant sodium channel AEDs. Seizure frequency and side effects were evaluated at six time points: baseline, titration, 3, 6, 9 and 12months. Results- Twenty-three patients had a baseline median of 4seizures/month with persisting partial-onset seizures, despite previous treatment with an average of 6.8 AEDs. Mean decreases in monthly seizure frequency were as follows: 3months 49.9% (P=0.011), 6months 55.4% (P=0.010), 9months 60.8% (P=0.002) and 12months 58.2% (P=0.011). Most adverse events were mild CNS-related symptoms and occurred transiently only during titration - there was no significant relationship (χ 2<1.5, P>0.1) between lacosamide dose and the presence of side effects at 3, 6, 9 or 12months. Conclusion- s - Drug-resistant patients rapidly titrated to high doses of lacosamide with simultaneous tapering of traditional sodium channel AEDs had marked reduction in CNS-related adverse events compared with patients treated in three previous pivotal trials that used fixed doses of concomitant AEDs.

Original languageEnglish (US)
Pages (from-to)228-233
Number of pages6
JournalActa Neurologica Scandinavica
Issue number4
StatePublished - Apr 2012


  • Antiepilepsy drugs
  • Epilepsy
  • Lacosamide
  • Side effects

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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