Lacosamide for seizure control in both children and adults
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The bottom line
Lacosamide is prescribed for seizures. Common side effects include drowsiness, dizziness, headache, incoordination, tremors, blurred vision, upset stomach, and difficulty with concentration and memory. Serious allergic reactions, heart and liver issues, depression, and suicidal thoughts can occur. Avoid alcohol and other depressants while taking lacosamide.
Prevention tips
Store lacosamide up, away, and out of reach of children.
Take lacosamide as prescribed.
Do not take more lacosamide than prescribed or more often than prescribed.
Do not break, crush, or chew the lacosamide tablets and capsules.
Use oral solution within 6-7 weeks after opening the bottle.
Store lacosamide at room temperature, away from light and moisture. Do not put it in direct sunlight.
Do not stop this medication suddenly, as this may cause seizures to return.
This really happened
A 48-year-old woman ingested an unknown number of lacosamide 100 mg tablets in a suicide attempt. She was taken to the emergency department 15 minutes after ingestion with vomiting and visual hallucinations. Past medical history included depression, traumatic brain injury, and seizures, as well as nonadherence to her medications. She was agitated and disoriented. Vital signs included elevated blood pressure and mildly elevated heart rate. Her EKG was abnormal with prolonged QRS intervals, which were treated with sodium bicarbonate.
At 2.5 hours after the overdose, she had a tonic-clonic seizure which was treated with lorazepam. She was also given naloxone to treat her decreased level of consciousness. She had a second seizure and was intubated for airway protection. She remained stable in the intensive care unit. She was extubated the next day and admitted to psychiatry.
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What is lacosamide prescribed for?
Lacosamide is prescribed for seizures. It is used in children and adults for partial-onset seizures and with other medicines for generalized tonic-clonic seizures. Common brand names are Vimpat and Motpoly XR, but it is also available in generic formulations.
How does lacosamide work?
Lacosamide stabilizes sodium channels in the brain, helping prevent abnormal electrical activity that can trigger seizures.
Side effects of lacosamide
Common side effects include dizziness, drowsiness, unsteadiness or difficulty walking, incoordination, headache, tremors, blurred vision, abnormal eye movements, nausea, vomiting, diarrhea and constipation. It can also lead to poor concentration and memory.Some of these side effects may improve over time.
More serious effects include heart problems, serious allergic skin rashes, and liver injury as well as anxiety, depression, and suicidal thoughts.
Is lacosamide a controlled substance?
Yes, lacosamide is a controlled substance. There is a possibility of abuse; it is a schedule V drug, which denotes the lowest level of abuse potential for a controlled substance.
What should I avoid while taking lacosamide?
While taking lacosamide, avoid alcohol as well as other drugs and supplements that cause drowsiness. Do not drive or engage in activities where drowsiness or dizziness could put you or others at risk until you know how lacosamide affects you. Lacosamide interacts with many other medications. Make sure your doctor knows about all the medications you take. This can help prevent harmful drug interactions and may allow your doctor to adjust the dose or timing of one or both medications if needed.Do not stop lacosamide abruptly, as this may result in seizures.
What should I do if someone accidentally takes lacosamide or takes too much lacosamide?
There is an increased risk of drowsiness and dizziness if someone accidentally takes a dose of someone else’s lacosamide or takes a double dose by mistake. If this occurs, seek medical advice.
Overdoses can result in more severe central nervous system effects including coma and cardiac effects including abnormal electrocardiograms, low blood pressure, and high or low heart rate.
In this situation, immediate medical attention is necessary. If someone swallows lacosamide, or if you have a question about using lacosamide safely, use the webPOISONCONTROL® online tool to get help, or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.
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