Efficacy and safety of intravenous lacosamide in refractory nonconvulsive status epilepticus

Abstract

Koubeissi MZ, Mayor CL, Estephan B, Rashid S, Azar NJ. Efficacy and safety of intravenous lacosamide in refractory nonconvulsive status epilepticus. Acta Neurol Scand: 2011: 123: 142–146. © 2010 John Wiley & Sons A/S. Background – Lacosamide (LCM) is a novel antiepileptic drug (AED) recently approved as an adjunctive therapy in the treatment of partial seizures in adults. LCM is available in oral and intravenous formulations, has linear pharmacokinetics and a unique mechanism of action. The aim of this study – To evaluate the safety and efficacy of intravenous LCM in the treatment of nonconvulsive status epilepticus (NCSE) after failure of conventional therapy. Methods – We retrospectively reviewed all patients with NCSE treated with LCM. We reviewed the clinical and electrographic changes before and after LCM administration. We also noted any reported side effects including electrocardiographic changes. Results – We report four cases of NCSE that were refractory to conventional treatment, but readily responsive to LCM. No side effects attributable to LCM were identified. Conclusions – Intravenous LCM may be safe and efficacious as an add‐on AED for the treatment of NCSE when standard therapy fails.

Observational Study of Intravenous Lacosamide in Patients with Convulsive Versus Non-Convulsive Status Epilepticus

“…Other adverse events reported were angioedema, allergic skin reactions, hypotension, and pruritus [17]. A number of case reports and retrospective studies have also demonstrated similar positive safety results with intravenous and non-parenteral lacosamide [16,19,20,23]. All other investigations of the agent in SE to date have been positive, and no other cases of angioedema have been observed.…”

“…The agent has been demonstrated to exert its anticonvulsant effects through the enhancement of slow inactivation of voltagegated sodium channels [18]; however, the precise mechanism of action of the drug has yet to be fully confirmed. Lacosamide is available in both oral and intravenous formulations, and in its intravenous form has shown promise as a treatment for SE [16,19,20]; nevertheless, prospective data of the use of this agent in such patients are limited.…”

Current Trends in Treatment of Status Epilepticus and Refractory Status Epilepticus

“…33 Phenytoin/fosphenytoin, valproic acid, levetiracetam, and phenobarbital can all be considered as potential adjunct second-line therapies. Intravenous lacosamide [34][35][36] and oral topiramate [37][38][39] have also been suggested for refractory SE.…”

Intravenous Antiepileptic Drugs in Russia

“…Использование ЛКСМ при ЭС в качестве первого или второго АЭП привело к купирова-нию статуса в 100% случаев, в качестве третьего -в 81%, а в качестве четвертого и на более позднем этапе -в 75%! ЛКСМ оказался эффективным при бессудорожном [8,9] и рефрактерном бессудорожном ЭС [10]. Отмечена высокая эффективность ЛКСМ при хорошей переносимости (всего 2 случая зуда и сыпи из 48 наблюдений).…”