Lacosamide Use in Institutionalized Mentally Retarded and Refractory Epileptic Patients (P01.041)

OBJECTIVE: To evaluate the efficacy and safety of lacosamide in institutionalized mentally retarded and refractory epileptic patients. BACKGROUND: Despite the introduction of multiple new antiepileptic drugs (AEDs) in the past 20 years, about 30% of patients with epilepsy continue to experience uncontrolled seizures or significant side effects. This resistance to treatment is even higher in people with mental retardation. In fact, the experience of AEDS in this kind of patients is very low and none of them has been proposed as a good therapeutic option. DESIGN/METHODS: This is a retrospective study and we reviewed the medical charts of all institutionalized mentally retarded and refractory epileptic patients receiving oral lacosamide until October 2012. These patients were classified according the severity of their mental retardation: mild, moderate and severe. Efficacy was determined according the seizure frequency during the month prior to treatment initiation and the month after the maximal dosage. RESULTS: Forty six patients (20 men and 26 women) aged 18-66 (mean 27.9±11.0) years were enrolled. Twenty two suffered perinatal anoxia, ten had epilepsy attributed to a structural cause, nine had epilepsy of unknown cause, and five had Lennox-Gastaut syndrome. The mean number of AEDs they were taking was 2.6±0.7 and the previous AEDs they had tried were 6.8±2.0. The mean follow-up was 4.6±2.4 months. Fifteen (33%) patients had at least a 50% seizure reduction, while a small decrease was obtained in another fifteen (33%). It was discontinued in six (13%) patients because of inefficacy. Side effects were reported in seven (15%) patients. These results were similar in all subgroups. CONCLUSIONS: Lacosamide seems to be effective and safe in mentally retarded and refractory epileptic patients according to our cohort and these results are independent of the degree of mental retardation of the patients. According to our results, lacosamide could be an important option for these patients. Supported by: UCB. Disclosure: Dr. Bermejo has received research support from UCB. Dr. Bermejo has received research support from UCB.