Vimpat Information:

Vimpat (generic name lacosamide) is a newer antiepileptic drug used to treat partial onset seizures (see below). The mechanism by which it works is currently unknown, however similar to other drugs it is thought to act through voltage gated sodium channels, which will reduce the occurrence of seizures. Vimpat is not to be used as a sole therapy in controlling seizures, rather it is used as an adjunct therapy to other conventional therapies (ex. Dilantin, Carbamazepine) in patients who are not adequately controlled with these medications. Another use for Vimpat is in diabetic neuropathy (nerve pain), however, this use is currently only indicated after other therapies have failed.

What are partial onset seizures?
Partial onset seizures involve a seizure in a particular area of the brain and include both simple partial seizures and complex partial seizures. Simple partial seizures are minor seizures that may be unnoticed by others and of very brief duration, they include feelings such as sudden unexplained feelings of fear, anger, happiness, experiencing unusual feelings or sensations, laboured speech or unable to speak at all, and a sense of spatial distortion. Simple partial seizures are usually remembered by the patient. Complex partial seizures include an aura (a visual disturbance, euphoria, feeling of depersonalization, or a deja vu feeling) and a loss of conciousness. Once the conciousness is impaired, the patient may show signs of lip-smacking, chewing or swallowing. There is commonly loss of memory and the patient may be unable to perform routine tasks such as walking. Both simple and complex partial seizures may be the precursor to the more commonly known seizure called a tonic-clonic seizure (patient is convulsing).

Vimpat Side Effects:

The following side effects have been observed with Vimpat at a dosage of 200mg. These are the most commonly observed side effects and their percentage occurrence is listed below.
-dizziness (16%)
-nausea/vomitting (6.5%)
-blurred vision (2%)
-double vision (6%)
-restlessness (4%)
-tremor (4%)

It is important to note that increasing the dosage of Vimpat is like to cause an increase in side effects, for example increasing to Vimpat 600mg increases the occurrence of dizziness to 53% and the occurrence of blurred vision and double vision to 16%.

Taking side effects into account, how effective is Vimpat?
Vimpat has shown to significantly reduce the frequency of partial onset seizures, certain studies have shown a 50% reduction in the frequency of seizures when Vimpat is added to other anti-epileptic drugs. In a general response of the effectiveness of Vimpat, the average patient reported it as a moderately effective treatment.

What are the potential drug interactions with Vimpat?
The following drugs may potentially interact with Vimpat, the patient should discuss thoroughly the potential for interactions with their primary care physician and/or pharmacist.
-lamotrigine
-pregabalin
-certain type of medications called beta blockers
-any antiarrythmic drug that may affect conduction of the heart

Vimpat Directions:

How do I take Vimpat?
Vimpat is supplied in dosages of 50mg, 100mg, 150mg, and 200mg tablets. The dosage range will vary anywhere from 100-800mg. The usual dosage range will be 400-600mg and will be increased slowly to this level. Vimpat may be taken with or without food.

Vimpat Precautions:

What are some precautions to taking Vimpat?
Vimpat is an effective medication, however it is important to note the following precautions.
1. Increase in suicidal ideation. In a very small number of patients, 1 in 500, there is a potential risk of increase in suicidal ideation. It is advised that the patient report any signs of depression, decreased mood, or any other mood changes immediately to their primary care physician.
2. The most common side effect of Vimpat is dizziness. Until the patient adjusts to this medication, he/she is advised not to drive, operate machinery, or perform any task that requires alertness.
3. Vimpat is not indicated for use in children (less than 18 years old), and generally elderly patients (greater than 65 years old) will require a smaller dosage.
4. Vimpat should not be discontinued abruptly, the dosage should be gradually discontinued over a period of at least 1 week to prevent an increase in rebound seizures.
5. Vimpat should not be given to patients with conduction problems of the heart (ex. Heart block, AV block) and should be used with caution in patients with severe cardiac problems such as ischemia and heart failure.
6. Patients with mild or moderate liver disease and patients with severe kidney disease should use lower dosages of Vimpat (maximum 300mg) and monitored more closely.