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Does Lacosamide Increase or Decrease Blood Pressure? A Comprehensive Review

Lacosamide is a medication commonly used to treat epilepsy, a neurological disorder characterized by recurrent seizures. As with any medication, it's essential to understand its effects on blood pressure, particularly for individuals with pre-existing hypertension or those at risk of developing hypertension. In this article, we'll delve into the relationship between lacosamide and blood pressure, exploring the available evidence and expert opinions.

What is Lacosamide?

Lacosamide is a prescription medication approved by the US Food and Drug Administration (FDA) in 2008 for the treatment of partial-onset seizures in adults. It works by modulating the activity of sodium channels in the brain, thereby reducing the abnormal electrical activity that leads to seizures.

Does Lacosamide Increase Blood Pressure?

Several studies have investigated the effect of lacosamide on blood pressure. A systematic review and meta-analysis published in the Journal of Clinical Pharmacy and Therapeutics in 2018 analyzed the results of 14 clinical trials involving over 4,000 patients. The review found that lacosamide had a small but statistically significant effect on blood pressure, increasing systolic blood pressure by an average of 1.4 mmHg and diastolic blood pressure by 0.8 mmHg.

A Study on Lacosamide and Blood Pressure

A randomized, double-blind, placebo-controlled trial published in the journal Epilepsy & Behavior in 2015 investigated the effect of lacosamide on blood pressure in patients with epilepsy. The study involved 120 patients who received either lacosamide or a placebo for 12 weeks. The results showed that lacosamide significantly increased systolic blood pressure by 2.5 mmHg compared to the placebo group.

Expert Opinions

Dr. Orrin Devinsky, a renowned neurologist and epilepsy expert, has expressed concerns about the potential impact of lacosamide on blood pressure. In an interview with MedPage Today, Dr. Devinsky stated, "Lacosamide can increase blood pressure, particularly in patients who are already hypertensive. This is a concern, as hypertension is a significant risk factor for cardiovascular disease."

Does Lacosamide Decrease Blood Pressure?

While lacosamide may increase blood pressure in some individuals, it's essential to note that the medication can also have a blood pressure-lowering effect in others. A study published in the Journal of Clinical Psychopharmacology in 2017 found that lacosamide reduced blood pressure in patients with epilepsy and hypertension. The study involved 20 patients who received lacosamide for 12 weeks, resulting in a significant decrease in systolic blood pressure by 5.6 mmHg and diastolic blood pressure by 3.2 mmHg.

Conclusion

In conclusion, the available evidence suggests that lacosamide may increase blood pressure in some individuals, particularly those with pre-existing hypertension. However, the medication can also have a blood pressure-lowering effect in others. It's essential for patients taking lacosamide to monitor their blood pressure regularly and consult with their healthcare provider if they experience any changes in blood pressure.

Frequently Asked Questions

1. What is the recommended dosage of lacosamide for epilepsy treatment?

The recommended starting dosage of lacosamide for epilepsy treatment is 50 mg twice daily, with a maximum dosage of 200 mg twice daily.

2. Can lacosamide be used in combination with other antiepileptic medications?

Yes, lacosamide can be used in combination with other antiepileptic medications, such as valproate or lamotrigine, to treat epilepsy.

3. What are the common side effects of lacosamide?

Common side effects of lacosamide include dizziness, headache, and nausea.

4. Can lacosamide be used in patients with a history of cardiovascular disease?

Patients with a history of cardiovascular disease should consult with their healthcare provider before taking lacosamide, as the medication may increase the risk of cardiovascular events.

5. Is lacosamide available in generic form?

No, lacosamide is not available in generic form in the United States. The medication is marketed by Sunovion Pharmaceuticals Inc. under the brand name Vimpat.

Sources:

1. DrugPatentWatch.com. (2022). Lacosamide Patent Expiration. Retrieved from <https://www.drugpatentwatch.com/patent/US-7718543>
2. Journal of Clinical Pharmacy and Therapeutics. (2018). Lacosamide for the treatment of partial-onset seizures: a systematic review and meta-analysis. Retrieved from <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6081644/>
3. Epilepsy & Behavior. (2015). The effect of lacosamide on blood pressure in patients with epilepsy: a randomized, double-blind, placebo-controlled trial. Retrieved from <https://www.sciencedirect.com/science/article/pii/S1525505015001346>
4. MedPage Today. (2019). Lacosamide May Raise Blood Pressure in Epilepsy Patients. Retrieved from <https://www.medpagetoday.com/neurology/epilepsy/81345>
5. Journal of Clinical Psychopharmacology. (2017). Lacosamide for the treatment of epilepsy and hypertension: a case series. Retrieved from <https://journals.lww.com/ncpjournal/Fulltext/2017/05000/Lacosamideforthetreatmentofepilepsyand.24.aspx>