Abstracts

Rationale: Epilepsy is associated with the occurrence of concomitant neuropsychological disorders, such as anxiety or depression, which may impair the quality of life of epileptic patients. Antiepileptic drugs play an important role in seizure control and may also affect neuropsychological functioning. The aim of the study was to evaluate the effect of lacosamide (LCM) on neuropsychological performance when administered as co-adjuvant treatment in epileptic patients with poorly controlled seizures. Methods: Multi-centre, observational, prospective study with a 3-month follow-up after treatment initiation with LCM. The study was conducted by 9 neurologists in Spain. Epileptic patients attending the investigator's office and complying with all selection criteria were invited to participate: patients older than 16 years on treatment with antiepileptic drugs who presented with poorly controlled seizures and were prescribed coadjuvant treatment with LCM under clinical practice conditions. Patients with previous diagnosis of neurological and/or neuropsychological disorders were excluded. At baseline (Visit 1) and at the 3-month follow-up visit (Visit 2), patient data were collected and the following scales were administered: Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI-S - STAI-T) (cut-off for pathological anxiety: ≥ percentile 70) and Side-Effect and Life Satisfaction Inventory (SEALS, rank 0-114 with lower scores indicating better prognosis). Results: A total of 53 patients were analyzed; 51% were female and 49% were male, the mean age was 44 (Standard Deviation, SD: 14). Epilepsies were classified according to aetiology: 44% were symptomatic and 56% possibly symptomatic. Based on location, 92% were focal, 4% generalized and 4% undetermined. The average duration of epilepsy was 18 years (SD: 16.1). At baseline, all patients were on treatment with antiepileptic drugs; 24% received sodium-channel blockers, 40% non-sodium channel blockers and 36% received both. The maintenance dose of LCM was 400mg daily (38/53; 75%) and 75% of patients did not deviate from the planned dose titration schedule (39/53). The mean number of seizures was 3.7 (SD: 4.4) during the month before the introduction of LCM and 1.1 (SD: 2.1) with 54% of patients seizure-free during the third month of follow-up. The average number of seizures during the 3-month follow-up was 3.5 (SD: 5.1) (25% were seizure-free). A reduction in state anxiety scores was reported in 34% of subjects (64%, no changes), 6% and 23%, respectively, for trait depression and anxiety. Patients showed a significant improvement in quality of life in all dimensions except dysphoria with a medium total SEALS score of 55 at Visit 1 and 48 at Visit 2. The rate of discontinuation due to an adverse event was 7.5%. Conclusions: LCM, showing a positive effect on seizure control, may also improve neuropsychological signs of depression and anxiety and quality of life in epileptic patients.