Lorcaserin, a selective serotonin receptor agonist commonly used for weight loss, is a potentially effective antiseizure medication for patients with severe epilepsy of childhood onset, according to a study in Neurology.
Researchers retrospectively reviewed medical charts of patients from New York University Langone Health (n=24), Children’s Hospital of Colorado (n=6), and Robert Wood Johnson Barnabas Health (n=6) who were treated with lorcaserin. Medical records were reviewed for patient demographics, epilepsy diagnosis and treatment(s), dosage and effects of lorcaserin therapy, and drug interactions.
The primary efficacy outcome assessed in the analysis was the median percentage change in mean monthly frequency of motor seizures (ie, tonic, tonic-clonic, focal seizures with prominent motor features, and drop atonic seizures) from baseline to last observation.
Caregiver reports in the patients’ medical charts were used to obtain information on seizure frequencies.
Diagnoses in the overall cohort were Dravet syndrome (n=20), Lennox-Gastaut syndrome (n=9), other treatment-resistant focal epilepsies (n=3), and generalized epilepsies (n=3).
Median treatment duration of lorcaserin was 10.8 months, and the mean dosage was 15.7 mg/day for adults and 13.7 mg/day for children. In the 35 patients included in the study, there was a significant mean percentage reduction in the monthly frequency of motor seizures from baseline (47.7%; z=−3.04; P <.01).
Changes from baseline to last observation in tonic-clonic, tonic, atonic, and focal seizures with motor features were 46.9%, 62.3%, 60.1%, and 54.6%, respectively. Approximately 42% of patients experienced >50% reduction in the frequency of motor seizures. During treatment, the most frequently reported adverse events were decreased appetite (19.6%), reduced attentiveness (17.1%), and weight loss (11.1%). A total of 5 patients ended treatment before 30 days because of adverse events.
Limitations of the analysis included its lack of a control or comparator group, small sample size, and retrospective nature of data collection.
“These promising preliminary findings support the need for randomized, controlled trials of lorcaserin for treatment-resistant epilepsies,” the researchers concluded.
Disclosures: Several authors report financial disclosures. Please refer to original manuscript for full list of funding and disclosures.
Tolete P, Knupp K, Karlovich M, et al. Lorcaserin therapy for severe epilepsy of childhood onset: A case series. Neurology. 2018;91(18):837-839.