eslicarbazepine / Generic mfg. - LARVOL DELTA

Trigeminal neuralgia secondary to giant saccular aneurysm/endovascular procedure – Is lidocaine block an old treatment with a new indication? (EHF-EHC 2025) - "Carbamazepine is the standard first-line treatment, although alternatives such as oxcarbazepine, lamotrigine, or pregabalin may be considered in cases of intolerance or poor response...Due to poor control of pain (15 episodes/month) and intolerance to carbamazepine (ataxia, vertigo), eslicarbazepine was introduced. Trials with oxcarbazepine, lamotrigine, pregabalin, and levetiracetam were ineffective and poorly tolerated...Given the refractoriness of symptoms, the patient was submitted to peripheral nerve block with 2% lidocaine at the auriculotemporal and supraorbital branches, resulting in marked improvement and a >50% reduction in frequency and severity of attacks. Peripheral nerve block with lidocaine is a safe, accessible, and effective option for symptom relief and should be considered in cases of secondary trigeminal neuralgia refractory to pharmacological treatment."

Ataxia • Brain Cancer • Cardiovascular • Movement Disorders • Musculoskeletal Pain • Neuralgia • Otorhinolaryngology • Pain • Solid Tumor • Vertigo

Trigeminal neural and hemifacial spasm – An uncommon association (EHF-EHC 2025) - "The patient started eslicarbazepine acetate 400 mg as a single daily dose, titrated to 800 mg, and the trigeminal neuralgia attacks were markedly reduced...This case underscores the rare co-occurrence of trigeminal neuralgia and ipsilateral hemifacial spasm, with evident vascular compression of the trigeminal nerve but no identifiable facial nerve compression. These findings support the hypothesis that facial nerve hyperactivity may result from aberrant activation of the trigemino-facial reflex pathway, even without direct anatomical compression."

Neuralgia

Safety and Efficacy of Eslicarbazepine Acetate in Children Diagnosed With a Focal Seizure Disorder: A Systematic Review and Meta-Analysis. (PubMed, Brain Behav) - "Though ESL increases the risk of adverse effects, it dramatically reduces seizure frequency in children with focal epilepsy. These risks require regular monitoring. Subsequent study should focus on long-term effectiveness, safety, and ways to mitigate the negative effects of ESL."

Clinical • Journal • Retrospective data • Review • CNS Disorders • Epilepsy • Pain • Pediatrics

Assessment of Adjunct Cenobamate on Seizure Outcome Using Long-term Electrocorticography (AES 2025) - "Table of Results LCM – Lacosamide ESL – Eslicarbazepine CBZ – Carbamazepine Long-term ECoG offers an objective method to assess antiseizure medication efficacy. Long-term ECoG offers an objective method to assess antiseizure medication efficacy. However, it also presents challenges such as inconsistent interrogation and uploads, resulting in a smaller sample size. In this retrospective analysis, 85% of patients treated with both CNB and RNS demonstrated a reduction in seizure count."

CNS Disorders • Epilepsy

Epilepsy-Related and All-Cause Healthcare Resource Utilization After Initiation of Adjunctive Cenobamate (AES 2025) - "The aim of this study was to evaluate the comparative effect of initiating cenobamate vs selected ASMs (brivaracetam, clobazam, eslicarbazepine, lacosamide, or perampanel) on epilepsy-related and all-cause inpatient (IP) and emergency room (ER) utilization rates. A retrospective observational study using de-identified electronic health records (EHRs) from 28 healthcare organizations representing ambulatory centers, hospitals, imaging centers, and clinics and medical offices (the Truveta database) identified adults (≥18 years) with an epilepsy diagnosis who initiated cenobamate or another selected ASM between January 1, 2020 and Dec 5, 2024. Initiation of cenobamate was associated with a significant reduction in both epilepsy-related and all-cause IP admissions and ER visits as compared to propensity-matched patients who similarly could likely have initiated cenobamate, but instead initiated other ASMs. The mechanism for why cenobamate was associated with fewer IP..."

HEOR • CNS Disorders • Epilepsy

Mortality Risk After Initiation of Cenobamate or Other Antiseizure Medications (AES 2025) - "The present real-world study examined the all-cause mortality rate in patients after initiating cenobamate vs the mortality rate in patients treated with selected antiseizure medications (ASMs) that have similar patterns of use in medication-resistant epilepsy. A retrospective observational study using de-identified electronic health records from 28 US health systems (Truveta) identified adults (≥18 years) with an epilepsy diagnosis who initiated therapeutic doses of cenobamate or another selected ASM (brivaracetam, clobazam, lacosamide, eslicarbazepine, or perampanel) between 1/1/2020-12/5/2024. This retrospective analysis shows that patients treated with cenobamate at therapeutic doses had lower mortality rates than patients treated with selected comparable ASMs commonly used for medication-resistant epilepsy. Further exploration of these results are needed to compare to other ASMs and non-ASM treatment options (e.g., surgery and neuromodulation), to compare to..."

CNS Disorders • Epilepsy

Machine Learning–Driven Identification of Key Predictors for Eslicarbazepine Treatment Response in Epilepsy (AES 2025) - "Higher ESL dose, lower baseline seizure frequency, and certain seizure types predict favorable ESL response. XGBoost and SVM models demonstrated strong predictive performance and may aid in patient stratification and personalized ASM selection. Future work should validate findings in multi-center cohorts and integrate neuroimaging or genetic biomarkers to enhance accuracy."

Late-breaking abstract • Machine learning • CNS Disorders • Epilepsy

The epileptology of Malan Syndrome: Are we missing seizures in intellectual disability-overgrowth syndromes? (AES 2025) - "Oxcarbazepine (4/12), eslicarbazepine (1/12), and levetiracetam (5/12) were the most effective ASMs. One-third of individuals with Malan syndrome have seizures. All had focal-onset seizures, associated with convulsive status epilepticus and drug-resistance in some. ASMs used to treat focal-onset seizures were effective."

Autism Spectrum Disorder • CNS Disorders • Developmental Disorders • Epilepsy • Genetic Disorders • Mental Retardation • Mood Disorders • Psychiatry

Exposure to Curriculum-Based Education Increases the Evidence-Based Use of Newer Anti-Seizure Medications for the Management of Focal Epilepsy Among Neurologists (AES 2025) - "Neurologist learners across the 3 CME programs were matched to claims data to identify them as prescribers of newer ASMs (defined as: brivaracetam, cenobamate, eslicarbazepine, lacosamide, and perampanel) in the 6 months prior to participation and 3 months after program participation relative to a propensity matched group of neurologists who did not participate in the educational programming. The reported data indicated that positive improvements in knowledge and competence across CME programming on the use of newer ASMs can translate to improvements in the clinical use of such medications. The next step is to determine if similar claims results are found 6 months after taking the CME programming."

CNS Disorders • Epilepsy

Clobazam pharmacokinetics in relation to concomitant oxcarbazepine and cenobamate doses (AES 2025) - "We identified patients taking cenobamate or oxcarbazepine/eslicarbazepine acetate. Cenobamate had the greatest impact on N-CLB/CLB ratio and the CLB and N-CLB clearance. OXC/ESL had a lower impact. The clearance of CLB was dose dependent while the clearance of N-CLB was not, suggesting that the inhibition of CYP2C19 was already maximal at OXC dose of 1200 and CNB dose of 100, while the induction of CYP3A4 increased at the higher doses."

PK/PD data • CNS Disorders • Epilepsy • CYP2C19 • CYP3A4

Clinical practice guidelines for the administration of third-generation anti-seizure medications. (PubMed, Seizure) - "This guideline provides a detailed evaluation of the current evidence and treatment recommendations regarding third-generation ASMs. This guideline will help clinicians to better understand these medications and offer guidance for clinical practice."

Clinical guideline • Journal • Review • CNS Disorders • Epilepsy

Economic evaluation of brivaracetam in the adjunctive treatment of patients with focal-onset seizure in Jordan. (PubMed, Medicine (Baltimore)) - "In addition to BRV, 3 treatment comparators were included in this economic evaluation: eslicarbazepine (ESL), lacosamide (LCM), and perampanel (PER). Compared to ESL and PER, BRV was associated with cost-savings. Compared to LCM, the BRV was cost-effective at the World Health Organization recommended willingness-to-pay threshold of 3× of Jordanian gross domestic product per capita."

HEOR • Journal • CNS Disorders • Epilepsy

Evaluating the risk of osteopenia-related adverse events with antiepileptic drugs: a pharmacovigilance study based on the FAERS database. (PubMed, Front Pharmacol) - "Previous studies have only identified a link between phenytoin and osteopenia, while the relationship between valproic acid and this adverse event remains controversial, and gabapentin and eslicarbazepine have not been systematically reported. The findings provide the first evidence of an association between these four antiepileptic drugs and osteopenia, offering insights and guidance for clinical recognition and prevention of such events."

Adverse events • Journal

Psychiatric vulnerability in epilepsy: Recognising the impact of antiseizure medication choice (ECNP 2025) - "Levetiracetam (LEV) and zonisamide (ZNS) show the highest rates of PBSEs and intolerable PBSEs (IPBSEs), frequently requiring dose adjustments or discontinuation [4]...In contrast, carbamazepine, valproate, lamotrigine, and gabapentin are associated with lower psychiatric risk...Newer ASMs, including eslicarbazepine and lacosamide, appear to offer more favourable psychiatric tolerability in patients with refractory epilepsy [5]... Psychiatric and behavioural side effects of ASMs are frequent and often under-recognised. Their impact may compromise both seizure control and psychological stability. A proactive, individualised approach that considers psychiatric history, seizure type, and ASM profile is essential."

CNS Disorders • Depression • Epilepsy • Mental Retardation • Mood Disorders • Psychiatry • Social Anxiety Disorder

Neuropsychiatric effects of antiepileptic drugs: Apropos of a case (ECNP 2025) - "These changes coincided with the introduction of Lacosamide and Eslicarbazepine acetate, alongside worsening seizure control...Neurology recommended suspending Eslicarbazepine, as a possible cause of hyponatremia, reducing Topiramate, associated with behavioral changes and hallucinations, and initiating Lamotrigine due to its better tolerability profile... This case highlights the importance of comprehensive evaluation in patients presenting acute psychiatric symptoms. Adverse effects of AEDs must be considered in the differential diagnosis, especially following recent medication changes, due to the potential for significant clinical improvement after appropriate treatment adjustments."

Clinical • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Epilepsy • Mood Disorders • Movement Disorders • Parkinson's Disease • Psychiatry • Suicidal Ideation

Misdiagnosis of Trigeminal Neuralgia and Misuse of Carbamazepine and Its Derivatives in Headache Disorders (IHC 2025) - "Objective Carbamazepine (CBZ) and oxcarbazepine (OXC) are well recognised first-line therapies in trigeminal neuralgia...Methods We conducted a service evaluation by searching clinical letters of patients seen at the headache clinic in a single tertiary-care headache centre to identify patients with any exposures to CBZ, OXC, or eslicarbazepine (ESL) from June 2014 to April 2024...Conclusion In patients referred to a tertiary headache clinic, trigeminal neuralgia is over diagnosed and inappropriately treated with CBZ and its derivatives resulting in no useful clinical outcome and substantial side effects. Migraine with lateralised facial involvement is a common presentation resulting in this misdiagnosis."

CNS Disorders • Migraine

Effects of dibenzazepine compounds on Nav1.2 channels and neuronal network activity: A systematic comparison. (PubMed, Eur J Pharmacol) - "The anti-seizure medications such as carbamazepine (CBZ), oxcarbazepine (OXC) and eslicarbazepine acetate (ESL) of the dibenzazepine family are structurally similar, but a comparative analysis under identical conditions is lacking. The structurally similar S-Lic showed significantly less use-dependent blocking effect, and a selective effect on distributed network bursts. These results emphasize that structurally similar dibenzazepine anti-seizure medications can exhibit substantial differences in activity on the ion channel and network level."

Journal • CNS Disorders • Epilepsy • NAV1

Seizure monitoring by combined diary and wearable data: A multicenter, longitudinal, observational study. (PubMed, Epilepsia) - P4 | "Wearable data capture seizure-related differences with daily resolution, differentiating between days with lower and higher seizure susceptibility. Combining diary-based clinical and wearable data bears the potential for developing a dynamic seizure detection and prediction system with daily resolution."

Journal • Observational data • CNS Disorders • Epilepsy

Eslicarbazepine as a Treatment for Vestibular Paroxysmia: Preliminary Results. (PubMed, Otol Neurotol) - "Eslicarbazepine shows good preliminary results achieving symptomatic relief in patients diagnosed with vestibular paroxysmia. Its enhanced safety profile with less adverse effects and drug interactions with respect to standard therapies could facilitate therapeutical adherence without detriment of its efficacy."

Journal • Otorhinolaryngology • Vertigo

Climate change and hyponatremia-related hospital admissions in people with focal epilepsy exposed to carbamazepine or its derivatives. (PubMed, Epilepsia) - "We report a high rate of hyponatremia-related hospitalizations among people with epilepsy occurring predominantly during summer. Climate change-related events, such as heatwaves and tropical nights, may trigger hyponatremia symptoms. Climate-regional vulnerability should therefore also be considered when selecting antiseizure medications and when counseling patients. We encourage interdisciplinary collaboration between clinicians and climate scientists in this emerging critical area."

Journal • Cardiovascular • CNS Disorders • Epilepsy • Heart Failure

The place of eslicarbazepine acetate in the treatment of epilepsy in adults (PubMed, Ideggyogy Sz) - "Eslicarbazepine acetate (ESL), a sodium ionchannel blocker as a third-generation antiseizure drug is a member of the firstline dibenzazepine antiseizure medications after carbamazepine (first generation) and oxcarbazepine (second generation). ESL used in monotherapy is recommended also in focal epilepsies (with or without secondary generalization) for newly diagnosed adult epileptic patients. It has been confirmed that ESL either in monotherapy or in combination drug treatment is an effective, well-tolerated and safe antiseizure medication."

Clinical • Journal • Review • CNS Disorders • Epilepsy

Real-world retention of newer ASMs, including lacosamide and brivaracetam as first or second therapies in adult-onset epilepsy. (PubMed, Epilepsia) - "Lacosamide and brivaracetam have at least similar real-world retention as lamotrigine or levetiracetam when used early in adult-onset epilepsy. This widens the therapeutic arsenal and the possibility of tailored ASM selection."

Journal • Real-world evidence • CNS Disorders • Epilepsy

Drug-resistant Epilepsy: Which Drugs are Substrates of P-glycoprotein and Which are Not? (PubMed, Curr Neuropharmacol) - "among the anticrisis medications, the following are likely substrates of P-glycoprotein: Phenytoin, Phenobarbital, Oxcarbazepine, Lamotrigine, Topiramate, and Lacosamide (less evidence). The following are probably not substrates: Brivaracetam, Zonisamide, Valproic acid, Perampanel, Gabapentin, and Vigabatrin. We have not obtained enough information about: Carbamazepine, Eslicarbazepine, Levetiracetam, Tiagabine, Felbamate, Pregabalin, Rufinamide, Ezogabine, and Retigabine."

Journal • CNS Disorders • Epilepsy

Switching from oxcarbazepine to eslicarbazepine in pediatric patients with focal epilepsy is safe and well-tolerated. (PubMed, Epilepsy Behav) - "Overnight switching from oxcarbazepine to eslicarbazepine is well tolerated in pediatric patients with focal epilepsy. Switching to eslicarbazepine is particularly beneficial for patients experiencing oxcarbazepine-related adverse effects."

Journal • CNS Disorders • Epilepsy • Pediatrics

Examining psychiatric and cognitive adverse effects of brivaracetam, clobazam, lacosamide, eslicarbazepine, and perampanel in a veteran population. (PubMed, Epilepsy Behav) - "In a population of veterans with epilepsy, clinicians should exercise caution in monitoring for cognitive and psychiatric adverse effects prescribed with the newer ASMs. Further research could help elucidate the dosage and delay at which these side effects would occur after treatment initiation."

Adverse events • Journal • CNS Disorders • Cognitive Disorders • Developmental Disorders • Epilepsy • Psychiatry