====== Cenobamate ======
Cenobamate (CNB) is a new Anti Seizure Medicine (ASM) recently approved by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for the treatment of focal-onset seizures in adults. CNB is not approved for use in children and adolescents.
==== Mechanism of Action ====
  * The precise mechanism is unknown[(:cite:pmid33993416>{{pmid>long:33993416}})]
  * reduce repetitive neuronal firing by blocking excitatory currents by promoting the inactivated state of voltage-gated sodium channels
  * enhance inhibitory currents at GABAA receptors
  * Positive allosteric modulator of GABA-A ion channel[(:cite:pmid32325146>{{pmid>long:32325146}})] 

Makridis et al[(:cite:pmid35937072>{{pmid>long:35937072}})] reported their experience with CNB in 16 pediatric patients with Drug Resistant Epilepsy (DRE). CNB was initiated in pediatric patients at 12.5 mg once a day (0.22 mg/kg/d) and then titrated-up by 0.47 ± 0.27 mg/kg/d every 2 weeks.Treatment with CNB resulted in seizure-free or a significant seizure reduction of > 50% in more than two thirds of their patients. The rates of seizure freedom or strong reduction of seizure frequency were in line with data published for adults[(:ref:todo)]. No serious adverse events occurred in their cohort. 

Most frequent adverse effects in their cohort were somnolence/fatigue which occurred during up-titration, in line with other reports[(:cite:pmid32396252>{{pmid>long:32396252}})]. Less frequently vertigo, nausea, balance disorder, diplopia, increased impulsive/agitated behavior, increased appetite with weight gain and impaired sleep quality were reported. 
{{tag>pharmacopoeia}}
==== References ====