• Vicente Villanueva, Francisco Javier López, José María Serratosa, Beatriz González-Giraldez, Dulce Campos, Albert Molins, Juan Rodriguez Uranga, José Angel Mauri, Javier Salas-Puig, Manuel Toledo, Juan Carlos Sánchez-Alvarez, Antonio Moreno, Pedro J Serrano-Castro, Rosa Ana Saiz-Diaz, Jesús González de la Aleja, Pilar de la Peña, and Montserrat Asensio.
• Hospital Universitario y Politécnico La Fe Valencia, Bulevard Sur, s/n, Carretera de Malilla, 46026 Valencia, Spain. Electronic address: villanueva_vichab@gva.es.
• Epilepsy Behav. 2013 Nov 1; 29 (2): 349-56.

AbstractLacosamide is approved as adjunctive therapy for focal epilepsies. The number of antiepileptic drugs (AEDs) tried is associated with prognosis. This multicenter, retrospective, observational study (LACO-EXP) in Spain in 500 adult patients with focal epilepsies examined the efficacy and tolerability of add-on lacosamide. Factors associated with better efficacy/tolerability were analyzed. After 12months, the responder rate (≥50% reduction in seizure frequency) was 57.1%, and the seizure-free rate was 14.9%. Efficacy was better when lacosamide was the first or second add-on AED, although there was a small chance to be seizure-free even for patients who had received ≤10 prior AEDs. The mechanism of action of concomitant AEDs is important in all the stages, but differences are smaller in the early stages. Lacosamide was generally well tolerated. A slower dosage-titration schedule was associated with a lower adverse event rate. Further investigation of the timing of initiation of lacosamide add-on therapy and ideal combinations of AEDs is required. © 2013.

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