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Available evidence suggests that these agents have similar efficacy, for example: An RCT comparing valproic acid and lacosamide found that the agents were equally efficacious when adequately dosed (e.g., 400 mg IV lacosamide)

Birn H, Willnow TE, Nielsen R, Norden AGW, Bnsch C, Moestrup SK, Nex E, Christensen EI

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doi: 10.1016/S2468-1253(20)30331-9

Most researchers report first noticing skin texture improvements around week six to eight