4.2.1 Epilepsy and other seizure disorders

For SPS Guidance on Phenytoin and Sodium Valproate monitoring in Adults in Primary Care please click here

For Controlled drugs/benzodiazepine prescribing patient treatment
agreement  Click Here

Cenobamate prescribing

Cenobamate is recommended for treating focal onset seizures in epilepsy, in accordance with NICE TA753
It is indicated for the adjunctive treatment of focal-onset seizures with or without secondary generalisation in adult patients with epilepsy who have not been adequately controlled despite treatment with at least 2 anti-epileptic medicinal products.
NICE recommend Cenobamate only if:
it is used as an add-on treatment, after at least 1 other add-on treatment has not controlled seizures, and treatment is started in a tertiary epilepsy service.
The specialist will initiate the medication accordingly and adjust the dose until the patient is stable.
Patients are expected to reach their stable dose after approximately 3 months, at which point GPs will be asked to continue prescribing. Some patients may require a slower titration, in which case the GP would not be asked to prescribe until the patient has reached their stable dose. 
On-going prescribing can be continued by a GP. The responsibility for titrating the dose or stopping treatment due to lack of effect or side effects remains with the specialist. The GP is not expected to titrate the dose.
Specialist Team Contact Details Email: kch-tr.epilepsycns@nhs.net

For NICE guidance TA753 Cenobamate for treating focal onset seizures in epilepsy Click Here