Cenobamate: An Appraisal Five Years On

Cenobamate is an antiseizure medication approved in 2021 as add-on therapy for adults with uncontrolled focal seizures. Early trials showed unusually high seizure freedom rates and a favourable tolerability profile, suggesting that cenobamate may represent an important therapeutic advance in the management of focal and other epilepsies. Here, we highlight the latest data from post hoc analyses and clinical studies suggesting that cenobamate is effective across all focal seizure types. It maintains efficacy and safety over the long term, allowing people to reduce their concomitant medications without compromising seizure control. While head-to-head studies are not available, these data, alongside indirect comparisons with other antiseizure medications, support cenobamate as a potentially important advance in the treatment of focal epilepsy.