Abstract
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.