Lacosamide: An Adjunctive Agent for Partial-Onset Seizures and Potential Therapy for Neuropathic Pain

tients remain seizure-free after initiating a single antiepileptic drug (AED), and 37 % of patients have seizures refractory to traditional AEDs.2 The explanation for re-fractory seizures can be multifactorial. For example, patients with refractory seizures may be nonadherent, develop adverse drug reactions, or experience drug interac-tions. Up to 60 % of patients with epilepsy report nonadherence to AEDs due to com-plex regimens, adverse drug reactions, cost, or denial of the disorder.3 Simple AED regimens with minimal adverse re-actions and drug interactions are needed. Despite the development of newer AEDs, the number of patients who respond to or are refractory to AEDs has not changed. This has spurred further development of improved AEDs for treatment of epilepsy. A novel AED, lacosamide (other names include harkoseride, SPM-927, ADD-234037) is a newer agent for the treatment of epilepsy. Like many other AEDs, la-cosamide has an effect on the voltage-gat-ed sodium channels (VGSCs). Unlike oth-er AEDs, lacosamide enhances the slow inactivation of VGSCs, making its mecha