Lacosamide neurotoxicity associated with concomitant use of sodium channel-blocking antiepileptic drugs: A pharmacodynamic interaction?

► Combining lacosamide with other anti-sodium channel-blocking antiepileptic drugs can lead to toxicity. ► Up to 17% of people may be affected by this pharmacodynamic interaction. ► The slow inactivated state might change the affinity of sodium channels for antiepileptic drugs. ► Reduction of concomitant anti-sodium channel-blocking antiepileptic drugs during lacosamide titration.