The effective management of
status epilepticus (SE) continues to be a therapeutic challenge. The aim of this study was to investigate the efficacy of
lacosamide treatment in an experimental model of self-sustaining SE. Rats were treated with
lacosamide (3, 10, 30 or 50mg/kg) either 10 min (early treatment) or 40 min (late treatment) after the initiation of perforant path stimulation. Early
lacosamide treatment significantly and dose-dependently reduced acute SE seizure activity; late treatment showed only a non-significant trend toward reduced seizure activity. Early
lacosamide treatment also dose-dependently reduced the number of spontaneous recurrent
seizures following a 6-week waiting period, with 70% reduction at the highest dose tested (50mg/kg); there was also a significant reduction in the number of spikes and the cumulative time spent in
seizures. Late treatment with high-dose
lacosamide (30-50mg/kg) reduced the number of animals that developed spontaneous recurrent
seizures (33% vs 100% in controls, P<.05), but did not significantly reduce seizure severity or frequency in rats that developed spontaneous recurrent
seizures. The results presented here suggest that
lacosamide deserves investigation for the clinical treatment of SE. Potential for disease modification in this rat model of self-sustaining SE will require further studies.