Side Effects of lacosamide: A Synthesis of Findings from 25 Studies

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Original Abstract of the Article

Major Research Findings

Lacosamide is a third-generation anti-epileptic drug that has been shown to be effective in treating epilepsy. 22 However, like all medications, it can cause side effects. Some of the common side effects of lacosamide include dizziness, headache, drowsiness, and diplopia. 24 Lacosamide can also cause more serious side effects, such as hyponatremia, skin rash, and elevated liver enzymes. 22 In rare cases, lacosamide can even lead to heart problems and psychiatric issues. 7 , 4 , 11 , 24

Reasons for Side Effects

Lacosamide works by affecting sodium channels in the brain, which are important for nerve cell communication. This effect can sometimes lead to side effects, as sodium channels are also found in other parts of the body, including the heart and muscles. 24 , 3

Common Side Effects

Dizziness

Dizziness is one of the most common side effects of lacosamide, which may be caused by the drug's effect on the balance system in the inner ear. 24 , 22

Headache

Headaches are also a common side effect of lacosamide. It is unclear exactly how lacosamide causes headaches, but it may be related to changes in blood flow in the brain. 24 , 22

Drowsiness

Drowsiness is another common side effect of lacosamide. It is thought to be caused by the drug's effect on the central nervous system. 24 , 22

Diplopia

Diplopia, or double vision, is a less common but possible side effect of lacosamide. It is thought to be caused by the drug's effect on the muscles that control eye movement. 24 , 22

Hyponatremia

Hyponatremia, or low sodium levels in the blood, can be a side effect of lacosamide. 22 , 5 This is likely due to the drug's effect on the kidneys, leading to increased sodium excretion in urine. 5

Skin Rash

Skin rash can be a side effect of lacosamide, and is often a sign of allergic reaction. 22 Lacosamide may also have a direct effect on skin cells, leading to inflammation. 24

Elevated Liver Enzymes

Elevated liver enzymes are another possible side effect of lacosamide, suggesting that the drug may put stress on the liver. 22 While the exact mechanism is not fully understood, it may be related to the drug's impact on liver cells. 24

Cardiovascular Effects

Lacosamide can have effects on the cardiovascular system, including arrhythmias, changes in heart rhythm, and potentially even cardiac arrest. 7 , 4 , 25 Individuals with pre-existing heart conditions or those taking medications for heart issues should be closely monitored while taking lacosamide. 7 , 4

Psychiatric Issues

Lacosamide may have negative impacts on mood and mental health, causing symptoms of depression and anxiety. 11 , 24 In rare cases, suicidal thoughts and behaviors have also been reported. 24 If you experience any changes in mood or mental health while taking lacosamide, it is crucial to seek immediate medical attention.

Countermeasures for Side Effects

Hyponatremia

If you experience symptoms of hyponatremia, such as headache, nausea, confusion, or weakness, consult your doctor immediately. They may monitor your sodium levels and adjust your lacosamide dose or consider alternative treatment options.

Skin Rash

If you develop a skin rash, consult your doctor right away. They will determine the cause of the rash and recommend appropriate treatment, which may include stopping lacosamide.

Elevated Liver Enzymes

If you have any concerns about elevated liver enzymes, contact your doctor for testing and advice. They may recommend adjustments to your lacosamide dose or suggest a different treatment approach.

Cardiovascular Effects

If you experience any unusual heart symptoms while taking lacosamide, such as chest pain, palpitations, or shortness of breath, seek immediate medical attention. It is crucial to inform your doctor about any pre-existing heart conditions or medications you are taking before starting lacosamide.

Psychiatric Issues

If you notice changes in your mood or experience any mental health concerns while taking lacosamide, it's vital to talk to your doctor or mental health professional. They can assess the situation and provide appropriate support or treatment.

Comparison Between Studies

Common Points

Most studies agree that lacosamide is generally safe and effective for treating epilepsy, with good efficacy and tolerability profiles. 22 , 24 , 2 However, it is crucial to be aware of potential side effects and discuss any concerns with your doctor. 1

Differences

Studies vary in their research design, sample size, and specific focus. Some studies focus on long-term efficacy and safety, 22 while others examine specific side effects, 24 or the effects of lacosamide in specific populations, such as pregnant women, 19 or patients with cancer-related seizures. 13

Points to Note Regarding Application to Real Life

Lacosamide is a valuable treatment option for many individuals with epilepsy, but it is important to be aware of its potential side effects. Before taking lacosamide, discuss your medical history and any pre-existing conditions with your doctor. They can help you weigh the benefits and risks and determine if lacosamide is appropriate for you.

Limitations of Current Research

While research on lacosamide is growing, there are still limitations. More long-term studies are needed to fully understand the long-term safety and efficacy of lacosamide, particularly in various patient populations. 14 , 8 Additionally, the effects of lacosamide in combination with other medications, particularly those affecting the central nervous system, require further investigation. 10

Future Research Directions

Future research should focus on understanding the long-term effects of lacosamide, particularly on cognition, mood, and cardiovascular health. 14 , 8 , 4 Studies exploring the drug's interactions with other medications are also essential, as well as research on optimal dosages for different patient groups. 10

Conclusion

Lacosamide is an effective antiepileptic drug with a generally favorable safety profile. However, it's important to be aware of potential side effects and communicate any concerns with your doctor. By working closely with your healthcare provider, you can ensure that lacosamide is a safe and effective treatment option for your specific needs.

Literature analysis of 25 papers
Positive Content
19
Neutral Content
4
Negative Content
2
Article Type
0
0
2
3
22
2.

Efficacy and tolerability of immediate switch from sodium channel blockers to Lacosamide.

Author: Talha ÖzgünOrhan, Kandemir YılmazMelek, Mert AtmacaMurat, Keskin GülerSelda, BuluşEser, DumanArda, ÇelebiÖzlem, GürsesCandan

Seizure reduction
Tolerable effects
Erectile dysfunction
Hyponatremia
Liver enzyme elevation
Pain
Rash

Lacosamide (LCM) is a new medication for epilepsy. This study found that switching directly to LCM from other drugs was generally effective in reducing seizures and was well-tolerated in patients with both focal-onset and generalized-onset epilepsy. The retention rate was high (94%), and 67% of patients were seizure-free at follow-up.

Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Buprenorphine may be effective for treatment of paramyotonia congenita.

Author: RavagliaSabrina, MaggiLorenzo, ZitoAntonio, ArceriSebastiano, GallottiPietro, AltamuraConcetta, DesaphyJean Francois, BernasconiPia, AlfonsiEnrico

PMC treatment

This study explored the use of non-antiarrhythmic sodium-channel blockers in two patients with paramyotonia congenita (PMC), a muscle disorder, to potentially avoid side effects or inefficacy of traditional treatments.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Evaluation of Cardiovascular Concerns of Intravenous Lacosamide Therapy in Epilepsy Patients.

Author: LuYan-Ting, LinChih-Hsiang, HoChen-Jui, HsuChe-Wei, TsaiMeng-Han

Status epilepticus treatment
Cardiac side effects

Intravenous lacosamide (LCM) is increasingly used for treating patients with status epilepticus, but concerns exist about its potential proarrhythmic effects, which need further investigation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Three cases in which drug-induced hyponatremia was improved by replacing carbamazepine with lacosamide.

Author: MorimotoMasahito, SuzakiIchiro, ShimakawaSeishi, HashimotoToshiaki, NakatsuTadanori, HamadaShigeaki, KyotaniShojiro

Improved hyponatremia

Carbamazepine can cause low sodium levels in the blood (hyponatremia). Switching to lacosamide, which has the same mechanism of action, may help resolve this issue.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

6.

A prospective, multicenter, noninterventional study in Taiwan to evaluate the safety and tolerability of lacosamide as adjunctive therapy for epilepsy in clinical practice.

Author: WuTony, ChuangYao-Chung, HuangHui-Chun, LimSiew-Na, HsiehPeiyuan F, LeeWang-Tso, ChengMei-Yun, TsaiMeng-Han, JouShuo-Bin, ChangChun-Wei, HsiehHsiang-Yao, DuXinlu, HellotScarlett, McClungCarrie, HungConnie

Safety
Tolerability

This study investigated the safety and tolerability of lacosamide (LCM) in real-world clinical practice for epilepsy patients in Taiwan. While efficacy was explored, the primary focus was on safety and tolerability, as previous studies had limitations in dose flexibility. The study aimed to better understand the real-world use of LCM for epilepsy treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

[Lacosamide associated with high-degree block in a patient with trigeminal neuralgia].

Author: Marin-GraciaM, Cantero-LozanoD, Garces-AntonE, Lopez-BravoA, Garrido-FernandezA, Navarro-PerezM P, Santos-LasaosaS, Garces-RedondoM

Focal seizures
Neuropathic pain
Cardiac arrest
Sudden death

Lacosamide is an anti-epileptic drug that works by affecting sodium channels in cell membranes. While usually having mild side effects, serious cardiac issues like arrhythmias and even cardiac arrest have been reported.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Spanish

8.

The effects of lacosamide on cognitive function and psychiatric profiles in patients with epilepsy.

Author: LiKuan-Ying, HuangLing-Chun, ChangYang-Pei, YangYuan-Han

Epilepsy treatment
Cognitive and mood problems

Anti-seizure medications (ASMs) can affect cognition and mood, impacting patients' treatment compliance and quality of life. Clinicians need to understand these effects and choose appropriate ASMs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Adjunctive lacosamide treatment for adult focal-onset epilepsy: focus on comorbid intellectual/developmental disorders and differing responses.

Author: DoğanEbru Apaydın, DoğanUmuttan, GençEmine, ErdoğanÇağla, GençBülent Oğuz

Seizure control

Lacosamide adjunctive therapy showed lower retention rates in patients with intellectual/developmental disorders (IDD) compared to those without IDD, but these rates were higher than those suggested with other AEDs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

The impact of lacosamide on mood disorders in adult patients with epilepsy: A systematic review.

Author: TonioloSofia, Di LorenzoFrancesco, BozzaliMarco, YogarajahMahinda

Potential mood improvement
Mood changes
Seizure control failure

The impact of lacosamide, an antiepileptic drug, on mood in epilepsy patients is unclear. Some studies suggest a benefit, others show no effect, highlighting the need for further research.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

12.

Therapeutic Drug Monitoring of Lacosamide: Is 10 to 20 mg/L a Suitable Reference Range for Patients With Epilepsy?

Author: Otero TorresSara, Juvany RoigRoser, Falip CentellasMercè, Casellas GibertMiriam, Estopiñá AntolíMónica, Rigo BonninRaül, Sala-PadroJacint Xavier, Jódar MassanésRamón

Adverse effects

The study investigates the relationship between lacosamide plasma levels above 10 mg/L and the incidence of adverse effects, given recent updates to the drug's reference range.

Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Outcome of cancer-related seizures in patients treated with lacosamide.

Author: ToledoM, MolinsA, QuintanaM, SantamarinaE, Martinez-RicarteF, Martínez-SaezE, Salas-PuigJ

Reduced AEDs
Seizure control
Status epilepticus control
Dizziness
Somnolence

This study described the clinical experience with lacosamide in neuro-oncological patients with cancer-related seizures. Lacosamide was effective in controlling chronic seizures in patients with either benign or malignant tumors. The success rate was greater in malignant tumors, and drug-resistant epilepsies were more likely associated with benign tumors. Lacosamide was also effective in treating status epilepticus in 73% of patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.

Language : English

14.

Evaluating the longer-term cognitive effects of adjunctive perampanel compared to lacosamide in a naturalistic outpatient setting.

Author: MeschedeCarolin, WittJuri-Alexander, RademacherMichael, von WredeRandi D, ElgerChristian E, HelmstaedterChristoph

Antiepileptic treatment
Cognitive profile

This study compares the long-term cognitive and behavioral side effects of two anti-epileptic drugs, perampanel and lacosamide, to determine which drug may be better tolerated by patients.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Lacosamide in trigeminal neuralgia: report of a case refractory to first- and second-generation anticonvulsants.

Author: AdamoDaniela, CoppolaNoemi, PecoraroGiuseppe, NicolòMichele, MignognaMichele Davide

Improved treatment compliance
Reduced side effects

Trigeminal neuralgia (TN) is often treated with anticonvulsants, but side effects can be a problem, particularly in older patients. Lacosamide, a newer anticonvulsant, has fewer side effects and shows promise for treating neuropathic pain associated with TN.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Favorable combinations of antiseizure medication with vagus nerve stimulation to improve health-related quality of life in patients with epilepsy.

Author: SauerVictoria, GlaserMartin, EllwardtErik, SaryyevaAssel, KraussJoachim K, RingelFlorian, GroppaSergiu, WinterYaroslav

Improved mood
Improved quality of life

This study aims to identify the best combinations of vagus nerve stimulation (VNS) and antiseizure medications (ASMs) for improving mood and quality of life in individuals with refractory epilepsy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

Lacosamide for refractory trigeminal neuralgia and other facial pain-Case report.

Author: MasrourShamin

Relieved facial pain
Facial pain

Lacosamide, a third-generation anticonvulsant, effectively relieved idiopathic and secondary facial pain in three patients who had not responded to standard treatments. All three patients experienced significant improvement in pain without any reported side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

[Use of antiepileptic drugs during breastfeeding : What do we tell the mother?]

Author: CrettenandM, RossettiA O, BuclinT, WinterfeldU

Safe breastfeeding

This study provides a comprehensive review of available data regarding antiepileptic drugs during breastfeeding and compares these data with information provided by the summary of product characteristics (SmPCs).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : German

20.

Lacosamide poisoning improved by hemodialysis.

Author: TakahashiHiroki, MuroyaTakashi, OkamotoYasutaka

Seizure control

Hemodialysis was effective in treating a severe case of lacosamide (LCM) poisoning in a 20-year-old woman. The patient’s blood LCM level decreased from 91.7 μg/mL on admission to 18.3 μg/mL after 4 hours of hemodialysis.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

21.

LACONORTE study: Efficacy and security of lacosamide as first add-on therapy for focal-onset epilepsy in real-life setting.

Author: Muñoz-LopetegiAmaia, López-GonzálezFrancisco Javier, Rodríguez-OsorioXiana, Pato PatoAntonio, Bellas LamasPaula, Abella-CorralJavier, Castro VilanovaMaría Dolores, GareaMaría José, Gil LópezJuan Antonio, Ruiz-MartínezJavier, PozaJuan José

Epilepsy treatment
Side effects

Lacosamide is efficacious and safe when used as first add-on therapy for focal-onset epilepsy. Most adverse events were mild and/or transient.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.

Language : English

22.

Comparing Safety and Efficacy of "Third-Generation" Antiepileptic Drugs: Long-Term Extension and Post-marketing Treatment.

Author: KwokCharlotte S, JohnsonEmily L, KraussGregory L

Refractory focal onset seizures treatment
Hyponatremia

Four 'third-generation' antiepileptic drugs (AEDs) - lacosamide, perampanel, eslicarbazepine acetate, and brivaracetam - were approved for adjunctive treatment of refractory focal onset seizures. Long-term efficacy and safety data from extension studies suggest that these AEDs provide new options in efficacy and tolerability.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

24.

The adverse-effect profile of lacosamide.

Author: LiJiyuan, SunMeizhen, WangXuefeng

Antiepileptic treatment
Cardiovascular abnormalities
Diplopia
Dizziness
Drowsiness
Headache
Heart damage
Hematotoxicity
Psychological symptoms
Skin rashes
Suicide risk

Lacosamide, a sodium channel blocker, is an effective anti-epileptic drug, but it has some side effects. Common side effects include dizziness, headache, and drowsiness, while rare but serious effects like skin rashes and psychological symptoms have also been reported.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

25.

Lacosamide Intoxication-induced Wide QRS Tachycardia Successfully Treated with Veno-arterial Extracorporeal Membrane Oxygenation.

Author: TakaiChihiro, MisumiKayo, KaitoDaiki, NishidaHiroaki, YoshiiMasami, YamadaSo, KobayashiTakaomi, KoinumaToshitaka, KadoyaTakashi, KimuraTakuya, HagiwaraYoshihiro, OguraTakayuki

Epilepsy treatment
Cardiac arrhythmia

Lacosamide, an antiepileptic drug, can cause life-threatening cardiac arrhythmias, particularly in patients with existing conduction system disorders. Veno-arterial extracorporeal membrane oxygenation can be used for treatment in severe cases.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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