Studies are underway for the use of lacosamide as a monotherapy for partial onset seizures, diabetic neuropathy, and fibromyalgia.

[6] The FDA has assigned lacosamide to pregnancy category C. Animal studies have reported incidences of fetal mortality and growth deficit.

[8] The side-effects most commonly leading to discontinuation were dizziness, ataxia, diplopia (double vision), nystagmus, nausea, vertigo and drowsiness.

[medical citation needed][9] A generally well-tolerated drug, the most commonly reported gastrointestinal side effects of lacosamide are nausea, vomiting, and diarrhea.

[11] Panic attacks; agitation or restlessness; irritability and aggression, anxiety, or depression; suicidality; insomnia and mania; altered mood; false and unusual sense of well-being.

Lacosamide appears to have a low incidence of psychiatric side effects with psychosis reported in only 0.3% of patients.

Suicidal behavior and ideation have been observed as early as one week after starting treatment with lacosamide, and is an adverse reaction to the use of most AEDs.

Many antiepileptic drugs, like carbamazepine or lamotrigine, slow the recovery from inactivation and hence reduce the ability of neurons to fire action potentials.

[19] Lacosamide does not affect AMPA, kainate, NMDA, GABAA, GABAB or a variety of dopaminergic, serotonergic, adrenergic, muscarinic or cannabinoid receptors and does not block potassium or calcium currents.

Lacosamide produced effects in animal models of essential tremor, tardive dyskinesia, schizophrenia, and anxiety.

[28] In adults, lacosamide demonstrates a low plasma protein binding of <15%, which reduces the potential for interaction with other drugs.

Lacosamide has a half life of about 12–16 hours, which remains unchanged if the patients is also taking enzyme inducers.

[29] 40% of the compound remains unchanged from its original structure, while the rest of the elimination product consists of metabolites of lacosamide.

The product is treated first with N-methylmorpholine, isobutyl chloroformate, and benzylamine, next with methyl iodide and silver oxide, forming lacosamide.

A few hundred such molecules were synthesized over several years and these were tested phenotypically in an epilepsy disease model performed in rats.

After its purchase of Schwarz Pharma in 2006, UCB completed the clinical development program and obtained marketing approval for lacosamide.

Its precise mechanism of action was unknown at the time of approval, and the exact amino acid targets involved remain uncertain to this day.

[50] In a multi center, multinational, placebo-controlled, double-blind, randomized clinical trial conducted to determine the efficacy and safety of different doses of lacosamide on individuals with poorly controlled partial-onset seizures, lacosamide was found significantly to reduce seizure frequency when given in addition to other antiepileptics, at doses of 400 and 600 milligrams a day.

[51] In a smaller trial of patients with diabetic neuropathy, lacosamide also provided significantly better pain relief when compared to placebo.

[33] Newer AEDs, including lacosamide, vigabatrin, felbamate, gabapentin, tiagabine, and rufinamide have been found to be more tolerable and safer than older drugs such as carbamazepine, phenytoin, and valproate.