I just saw this info re: lacosamide (Schwarz Biosciences) on the American Pain Foundation site and pass it along to this forum. It is also known as harkoseride or ADD234037 and from looking at the structure it is a synthetic derivative of the naturally occuring amino acid serine BUT IT IS NOT A NATURAL COMPOUND ITSELF! If this is old news I'm sorry but I don't remeber seeing it before. In any case the 1st 2 links are descriptions of 2006 Phase III trails of lacosamide which look promising for treatment of pain associated w/diabetic PN.

http://www.medscape.com/viewarticle/546044

http://www.docguide.com/news/content...2573470065259A

The next link is to a Phase III study which predates the above work but also showed promising results.

http://www.bioportfolio.com/aug_05/2...sitive_in.html

This last link may be way too much info and an info overload but it appears to be a detailed and complete, recent (2007) summary of the PRECLINICAL pharmacology of lacosamide and a very detailed and complete description of the biochemistry of neuropathic pain - VERY COMPLEX as we all know. Lacosamide seems to have a novel mechanism of action for an anticonvulsant or antiepileptic drug (AED), at least as much as is understood.

I haven't digested this paper in its entirety but a VERY BRIEF paraphrase would be that a key aspect of lacosamide seems to be that it has a dual mode of action as an analgesic and as anticonvulsant. In particular, it enhances slow inactivation of voltage-gated sodium channels but it does not affect fast inactivation. The significance of the selectivity seems to be that slow inactivation of these sodium channels is a critical component in the pathophysiology of epilepsy and neuropathic pain both of which exhibit hyperexcitability of neurons with a lower activation threshold and/or an exaggerated neuronal response. The mechanism of hyperexcitability is still not well understood in the scientific community and certainly not by me.

http://www.bioportfolio.com/aug_05/2...sitive_in.html

There were AE''s (Adverse Events or side affects) associated w/ the treatment but overall the 400mg dose seemed to combine the best efficacy w/ the fewest side affects and the fewest number of patients opting out of the trials due to the SE's.

Maybe worthwhile to add to the burgeoning database.

Alkymst

It's 2+ years down the road for approval both in the US and Internationally AND for DPN and Seizures? A double double blind study? The overall drop out rate seems awfully low and the s/e's minimal as well...Cannot WAIT to see it hit the streets!

Hope is ALWAYS around the corner? - j

Good catch.

Why is everything for diabetic neuropathy???!!! There are plenty of us out here with serious neuropathy that aren't diabetic and..no hope of ever recovering. It just doesn't make sense to me sometimes.

Billye

at best and say that diabetes is still a more recognized disease state as well as the complications associated w/ it. Unfortunately for many of us w/ idiopathic and other numerous types of neuropathies the numbers of patients aren't as evident and we are a "silent" majority of sorts - just my guess. I don't have an answer much less a good one.

Alkymst

in the regular sense...the NA seems to be in it's own world. I will note that there was NOT one professsional represatative of that association at last years' NORD conference...a conspicous absence IMHO.
The Diabetics and those on CHEMO for cancers HURT, there are just a whole lot MORE of them, ergo they have a louder voice. They are also very lucrative pharmaceutical markets for the future, and on, etc.....

What I NEVER EVER GOT was why is Diabetic PN 'PAINFUL' and other PN's NOT? No offense to any diabetics here...I believe we all HURT to our varying undefined degrees equally and democratically. Just the insertion of PAINFUL in only one instance, well, it IRKS me? After all, we ALL HURT HERE, I believe. Hugs to all! - j

I think it is because the cause of their PN is known(diabetes), so during a study knowing the cause eliminates an important variable and makes it more scientifically valid.

No one in the medical or research fields likes patients with problems with unknown causes. It makes them feel inadequate, so they avoid us.... Ha ha. May be a grain of truth in it, though.