Lacosamide effects on pain management in patients with multiple sclerosis: A randomized, double-blind, placebo-controlled clinical trial
In brief
Lacosamide patients with MS reported improvement at 12 weeks: 90% vs 38%
In a 12-week randomized trial, 90% of adults taking lacosamide reported clinical improvement, compared with 37.5% taking placebo. Lacosamide also reduced pain severity and interference, with no serious adverse events reported; whether benefits persist beyond three months remains unknown.
- Journal
- Multiple sclerosis and related disorders (Q1)
- Published
- 29 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Elnaz Nouri, Seyed Mohammad Baghbanian, Monireh Ghazaeian, Abolfazl Hosseinnataj, Ebrahim Salehifar
- PMID
- 42832970
- DOI
- 10.1016/j.msard.2026.107952
Why clinicians should know about it
- Picked for Anesthesiology and Pain Medicine (paper of the day, 6 October 2026): Lacosamide lowers MS‑related pain severity
Abstract
BACKGROUND: Multiple sclerosis (MS) frequently presents with pain, a debilitating symptom for which effective treatments are scarce. This study aims to assess the potential analgesic effects of Lacosamide in individuals with MS. METHODS: This randomized, double-blind, placebo-controlled trial investigated the efficacy of lacosamide in adult patients with definite MS and moderate-to-severe MS-related pain (Brief Pain Inventory [BPI] severity score ≥4). Participants were randomly assigned (1:1) to receive either lacosamide or a matching placebo for 12 weeks. Lacosamide was titrated weekly to a maximum tolerated dose of 200 mg twice daily. The primary outcome measure was the change in BPI pain severity score from baseline to month three. Secondary outcome measures included pain interference (BPI), neuropathic pain symptom inventory (NPSI), patient global impression of change (PGIC), quality of life (SF-36), and safety assessments. RESULTS: The study demonstrated balanced baseline characteristics between treatment groups. Compared to placebo, lacosamide led to a statistically significant decrease in pain severity (P = 0.001), achieving targets of pain below 4 and a 50% reduction. Pain interference and total NPSI scores also improved significantly (P = 0.025; ∼70% reduction). By month three, 90.0% of lacosamide patients reported clinical improvement vs. 37.5% in placebo (P < 0.001). SF-36 scores improved (P = 0.022). No serious adverse events occurred. CONCLUSIONS: Lacosamide (up to 400 mg/day) significantly reduces chronic pain severity and interference in MS patients, improving their global impression of change and quality of life. With an acceptable safety profile, it's an effective treatment option for MS-related pain.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.