The impact of lacosamide on mood in adult patients with epilepsy remains largely unknown, according to a systematic review of the literature. While studies of older antiepileptic drugs have investigated the drugs' effects on mood, there is little evidence for new drugs such as lacosamide. Evidence from studies, including retrospective and comparative drug studies, suggests that lacosamide has no negative effect on mood, and could potentially benefit patients with depression. However, the authors concluded that multicenter, randomized, controlled, double-blind studies are needed to assess the drug's impact on mood in epilepsy patients given the relatively low evidence level of currently available studies. The findings underline the importance of mood evaluation when choosing the most appropriate antiepileptic drug.

A retrospective longitudinal study has found that perampanel and lacosamide, two third-generation antiepileptic drugs, had no negative impact on cognitive function or behaviour in epilepsy patients. Lacosamide was even found to potentially improve cognitive abilities. Both drugs were similarly effective at controlling seizures. The study analysed records from 94 patients who underwent neuropsychological assessment before and during treatment, enabling a comparison of antiepileptic drug tolerability in a naturalistic outpatient setting. The findings provide further evidence supporting the use of third-generation antiepileptic drugs as safe and effective treatment options for people living with epilepsy.

The RELACOVA study investigated the efficacy and tolerability of lacosamide in a cohort of 158 patients with partial-onset epilepsy in Spain over 12 months. The study found that lacosamide was effective and well-tolerated, with 47% of patients responding to treatment and 24% becoming seizure-free. The study also suggested that combination therapy with lacosamide and a non-sodium channel blocker had better efficacy and fewer adverse events than combination therapy with another sodium channel blocker. The authors suggest that further investigation of lacosamide combination therapy is warranted. This is the largest observational study of lacosamide in a real-world setting, and the findings support the use of rational polytherapy in the treatment of patients with refractory partial-onset epilepsy.

Researchers have found that lacosamide monotherapy, a drug approved by the FDA for adjunctive treatment of partial-onset seizures in adults, may be a valuable option as a first-line or conversion therapy for patients with partial-onset seizures. The study, which retrospectively reviewed patient charts for efficacy and tolerability, found that more than two-thirds of patients were seizure-free on LCM monotherapy, with only mild to moderate side effects in some patients. The drug was withdrawn in just 4.5% of patients, with most discontinuing due to lack of efficacy rather than side effects. The study was carried out in six Spanish hospitals and included patients who were new to drug therapy as well as those who had previously been treated with AEDs. The drug has not yet received EMA approval for use as a monotherapy in the European Union.

Long-term safety and efficacy of lacosamide, an antiepileptic drug, were evaluated in an open-label extension trial involving 370 patients with partial-onset seizures for up to 8 years of exposure. Lacosamide reduced seizure frequency by 47-65% and responses by ≥50% in 49-63% of completer cohorts. Dizziness (39.7%), headache (20.8%), nausea (17.3%), diplopia (17%), and fatigue (16.5%) were among the common adverse events, but only dizziness (2.2%) led to discontinuation in more than 2% of patients. It was generally well-tolerated and no new types of adverse events emerged during the trial. Long-term open-label extension trials like these can determine whether medication side effects increase in frequency or severity with time or become apparent after prolonged treatment, but they are prone to patient selection bias.

A recent study has found that adjunctive lacosamide therapy for partial-onset seizures did not pose any specific safety concerns. The study monitored the incidence of predefined cardiovascular and psychiatric-related treatment-emergent adverse events (TEAEs) in epilepsy patients when initiating adjunctive therapy with lacosamide or another approved antiepileptic drug according to standard medical practice. The study found that 0.8% of patients adding lacosamide experienced a predefined CV-related TEAE, compared to 0.8% of patients taking other AEDs. Similarly, predefined psychiatric-related TEAEs were reported by 4.1% of the lacosamide cohort and 5.5