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Lacosamide for the treatment of partial-onset seizures

Matthew H Wong and Nathan B Fountain

Lacosamide is a recently approved antiepileptic drug for the adjunctive treatment of partial-onset seizures in adults. It is a functionalized amino acid with a novel mechanism of action, possesses excellent oral absorption, has negligible protein binding, interacts minimally with other antiepileptic drugs and is excreted mainly in the urine. It is efficacious at significantly reducing the frequency of partial-onset seizures by approximately 36–39% at doses of 400 mg/day, compared with just 10–20% reduction for placebo. It is generally well tolerated, with its main dose-related side effect being dizziness. It has no known endorgan toxicities, although it can increase the PR interval. It is likely to be an important contribution to the treatment of individuals with refractory partial-onset seizures.