How to manage patients receiving adjunctive cenobamate

Wed, 20 Aug 2025 17:58:16 +0000

William E. Rosenfeld, MD, FAAN, The Comprehensive Epilepsy Care Center for Children and Adults, St Louis, MO, discusses the use of cenobamate in patients with uncontrolled focal epilepsy. Studies have shown that cenobamate use enables rapid and sustained seizure control, achieving unprecedented rates of seizure freedom. Dizziness and sleepiness have been identified as more common side effects, both of which can be managed through adjustment of concomitant drug doses. Proactive lowering of clonazepam or phenobarbital can help to alleviate sleepiness, as can lowering phenytoin for dizziness. Lacosamide is often proactively lowered during cenobamate titration when the patient is taking a dose of 500mg or more. This interview took place at the American Academy of Neurology 2022 Congress in Seattle, WA.