Levetiracetam - A new therapeutic option for epilepsy

The therapeutic effectiveness of levetiracetam (Keppra®), a new adjunctive agent for use in the control of epilepsy, has been documented in a number of multicenter, randomized, double-blind placebo-controlled trials in the U.S. and Europe. A ≥50% reduction in weekly seizure frequency was achieved in 28.6-39.5% of patients with refractory partial onset seizures who were treated with dosages ranging from 1,000 mg to 3,000 mg per day. Levetiracetam can be started at an effective dose, in contrast to the slow titration required with several other new antiepileptic drugs (AEDs). It has a rapid onset of action, with a statistically significant therapeutic effect observed within 1 day to 2 weeks after initiating therapy. Levetiracetam is generally well tolerated, with somnolence and asthenia being the most frequently reported adverse effects. The absence of hepatic metabolism and insignificant protein binding of levetiracetam result in this anticonvulsant being free of interactions with other drugs. Levetiracetam should be considered an important addition to the AED armamentarium for the treatment of epilepsy.