Abstract
Treatment with lacosamide (LCM) in monotherapy and adjunctive therapy of focal epilepsy is available in the Czech Republic for 8 years. Experience with its use during pregnancy and lactation is minimal.
Lacosamide is used and efficient in women with epilepsy (WWE). If other antiepileptics suitable for the treatment of focal seizures with documented low teratogenicity (lamotrigine, levetiracetam) have failed or a woman has not tolerated them, the question is what other antiepileptic treatment can be recommended? If LCM in a woman with focal epilepsy at fertile age is proven to control seizures, can it be continued for the duration of pregnancy planning? A teratogenic risk is not known.
Is it necessary to modify the LCM dose during pregnancy? The data on possible changes in the plasma concentration of LCM during pregnancy are not available. If a woman taking LCM gives birth, can she breastfeed? A potential risk to breastfed infants/children is not known.
Animal studies have shown that LCM is excreted in breast milk which can be expected in humans as well due to low binding with plasma proteins. The article presents data from the period of pregnancy and lactation in a patient on LCM monotherapy.