Cenobamate

Czech version

Authors: prof. MUDr. Milan Brázdil, Ph.D.
Authors‘ workplace: 1. neurologická klinika ; LF MU a FN u sv. Anny v Brně ; Centrum pro epilepsie Brno
Published in: Cesk Slov Neurol N 2022; 85(5): 417-420
Category: Drug Profile

Overview

Cenobamate (CNB) is a novel antiepileptic drug with a dual mechanism of action indicated for the adjunctive treatment of focal-onset seizures in adult patients with epilepsy inadequately controlled despite prior treatment with at least two antiepileptic drugs. In therapeutic doses, it most likely acts through positive allosteric modulation of γ-aminobutyric acid type A (GABAA) receptors at the non-benzodiazepine binding site, as well as preferential inhibition of persistent sodium currents and enhancement of the deactivated state of voltage-gated sodium channels. Numerous clinical experiences with cenobamate testify to its high effectiveness in terms of achieving seizure-freedom, even in patients who are still drug-resistant. At the same time, CNB appears to be a well-tolerated drug with a minimum of adverse events. However, attention must be paid to potential pharmacokinetic interactions and gradual titration when starting treatment. It is contraindicated in patients with a rare familial occurrence of a short QT interval. Its recommended dosage is 200–400 mg/d taken in one daily dose.

Keywords:

pharmacoresistance – Epilepsy – cenobamate – adjunctive treatment

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