Lacosamide, an antiepileptic drug (AED) approved for partial-onset seizures works primarily by enhancing slow inactivation of voltage-gated sodium channels leading to stabilization hyperactive neural circuits. While the drug can provide benefit, it also has a number of side effects in as many as 30-40% of patients according to data across publications included within Epilepsy & Behavior. The most commonly reported problem, dizziness, is experienced by an estimated 25 percent of users and tends to get worse when the dosage increases from a daily dose of about 200 mg to one approaching the top range. It is a side effect that can make it difficult to perform daily activities, especially for people who need attention and balance (like driving).
Fatigue (occurring in around 16% of people) is another common side effect, as are a headache (14%). Fatigue is a common adverse effect, especially in the early phase of treatment and for starting doses above 100 mg/day. A: Neurologists have found the phase of slow titration, which decreases those side effects by almost 20%. Headache (which is less common) also hopefully resolves with time as your body adjusts to the medication.
Cognitive disorders such as memory problems, and difficulties in concentration have been observedapparently with between 8–10% of the patients. These cognitive effects are particularly troubling to people with high daily cognitive needs. These symptoms are often controlled by modifying the dosing schedule or decreasing of dosage. Occasionally, cognitive impairment is so severe that other treatments are attempted because it can clearly create a huge reduction in lifestyle.
Some 1012% of patients may experience gastrointestinal side effects, including nausea and vomiting. These side effects are dose-related and may be minimized by taking lacosamide with a meal. Additionally, dividing the daily dose further has been demonstrated to enhance gastrointestinal tolerance by approximately 15%. Eating a meal may also help alleviate nasea, and antiemetics can control it while maintaining the anticonvulsant benefit of lacosamide in case that did not work adequately.
Cardiovascular effects are also rare and occur in less than 1% of cases, but can be significant as they include prolonged PR interval. This extended action has the potential to cause arrhythmias, especially in patients with known cardiac diseases. Regular electrocardiograms (ECGs)- Early detection and intervention are recommended for individuals at higher risk. It could also lead to significant adverse effects in certain situations, thereby requiring dose modifications or other therapeutic measures.
In around 6% of users we have evidence that psychiatric side effects in the form of depression and irritability can occur. These signs typically tend to occur frequently in patients with pre-existing mood disorders. Monitoring mental health throughout the treatment is also important because mood related changes which might go unnoticed could lead to a serious state in near future. For example, healthcare providers often manage mood stabilizers or adjust anticonvulsant therapy to a patient's individual needs.
To do this, it is important to understand the lacosamide side effects so you can manage its efficacy and safety. By using a targeted strategy, some of these side-effects can be downplayed or well controlled such that patients do not miss out on the seizure control benefits afforded by lacosamide altogether whilst maintaining quality of life.