Cenobamate for treating focal onset seizures in epilepsy

Cenobamate (Ontozry) is available on the NHS as a possible treatment for focal onset seizures with or without secondary generalised seizures in adults with drug-resistant epilepsy that has not been adequately controlled with at least 2 medicines.

Under new guidance published by NICE, cenobamate is only available 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 specialised epilepsy service (tertiary care).

Why the committee made these recommendations

The short-term clinical evidence published by NICE- the National Institute for Health and Care Excellence - shows that cenobamate reduces the number of seizures. It also increases how many people stop having any seizures. However, it is uncertain how this compares with other anti-seizure medicines because cenobamate has not been directly compared with them. According to NICE, the results of an indirect comparison are uncertain because the clinical trials included are short and have different designs. Because it is unclear how the benefit of cenobamate compares with its risks, it should only be started in a tertiary epilepsy service.

Concerned about this treatment option

Your healthcare professional or GP will guide you with more information on the medication, talk with you about your options, and will listen to your views and concerns. You could also involve your family and carer in this if you wish. If you were prescribed cenobamate within the NHS outside of these recommendations – before the guidance was written – your treatment should not be affected but you should consult your doctor to decide when it is appropriate to stop the medication.

If you have been prescribed cenobamate but do not meet the criteria above, please talk to your doctor. For more information Overview | Cenobamate for treating focal onset seizures in epilepsy | Guidance | NICE

Call our Helpline

If you have any concerns around your epilepsy medication and would like to talk to someone, please call our Epilepsy Helpline on 01494 601400 (Mon-Fri 9am-4pm, Wed 9am-7.30pm).