(FDA approved in bold)

• Partial-onset seizures (adjunctive in ages 17 and older)
  
• Neuropathic pain

• Lacosamide likely acts by enhancing slow inactivation of voltage-gated sodium channels, resulting in stabilization of hyperexcitable neuronal membranes and inhibition of repetitive neuronal firing
  
• It also binds to collapsin response mediator protein-2 (CRMP-2), which causes changes in axon outgrowth
  
• Unlike many AEDs, does not appear to affect AMPA, kainate, NMDA, or GABA receptors and does not block potassium or calcium currents

• Seizures – goal is the remission of seizures. Continue as long as effective and well-tolerated. Consider tapering and slowly stopping after 2 years without seizures, depending on the type of epilepsy

• Increase to highest tolerated dose
  
• Epilepsy: consider changing to another agent, adding a second agent or referral for epilepsy surgery evaluation. When adding a second agent keep in mind the drug interactions that can occur

• Epilepsy: Designed for use with other AEDs. No interactions with AEDs in terms of levels but risk of AEs and hepatic dysfunction increase with polytherapy

• No regular blood tests are recommended