Evaluation of effects of lacosamide treatment on sleep, cognitive functions, mood and quality of life in focal epilepsy

Epilepsy is defined as the brain's susceptibility to seizures and affects approximately 1% of the population. Epilepsy and sleep are two dynamic processes that closely affect each other. In line with electrophysiological and clinical evidence, it has been shown that neuronal activity and biochemical structure during sleep affect the neuronal mechanisms that trigger epileptic seizures, and that epileptic seizures and epilepsy also cause sleep-related complaints by making changes in sleep structure. Sleep disorders are more common in patients with epilepsy than in the normal population, however insomnia leads to an increase in seizure frequency and has negative effects on quality of life. Unfortunately, there are a few number of studies in the literature that focused on the effects of anti-seizure drugs (ASD) on objective and subjective sleep parameters. Likewise, mood disorders and cognitive disorders, especially depression, are more common in epilepsy patients and have a negative impact on the quality of life of patients. In this context, the aim of our study is to evaluate the effects of lacosamide, a new generation ASD with proven effectiveness in the treatment of focal epilepsy, on subjective and objective sleep parameters, depression, cognition and quality of life, and to determine whether it is superior to older generation drugs in terms of these parameters. Patients with focal epilepsy who had add-on lacosamide or switched to lacosamide from their current treatment were included in the study. Before and after 6 months of lacosamide treatment, sleep parameters, daytime sleepiness, depression, cognitive functions and quality of life were evaluated with polisomnography and relevant scales, respectively. All parameters and scales obtained showed that lacosamide treatment did not have any negative effects on sleep parameters, daytime sleepiness, depression, cognitive functions and quality of life. This study is the first to measure the effect of lacosamide treatment on sleep quality in patients with focal epilepsy with an objective method such as polysomnography. As a result of our study, it was determined that lacosamide did not have a negative effect on objective and subjective sleep parameters, cognitive functions, depression and quality of life in patients with focal epilepsy. Considering the negative effects of old generation ASDs on the parameters examined, the results of this study are useful in terms of guiding rational drug choices. However, there is a need for further studies on this subject in larger patient groups. Keywords: epilepsy, sleep, polysomnography, depression, quality of life, cognition