Magazine article Clinical Psychiatry News

Levetiracetam Controls Seizures in Refractory and Elderly Patients: Two Postmarketing Studies

Magazine article Clinical Psychiatry News

Levetiracetam Controls Seizures in Refractory and Elderly Patients: Two Postmarketing Studies

Article excerpt

HONOLULU -- Levetiracetam substantially reduces seizures in both treatment-refractory and elderly populations, according to two postmarketing studies presented at the annual meeting of the American Academy of Neurology.

A retrospective study looked at 176 patients with treatment-refractory, partial-onset epilepsy. Their ages ranged from 3 to 77 years. Almost 80% of the patients had failed three or more antiepileptic drugs, and 18.1% had failed seven or more. Patients had had epilepsy for a mean of 19.6 years (range 1-52 years), and most had one-to-four seizures per month, said Dr. Brien Smith of the Henry Ford Health System, Detroit.

Most patients started levetiracetam (Keppra) at a dosage of 500 mg or 1,000 mg/day; Final dosages ranged from 250 to 6,000 mg/day. The duration of levetiracetam treatment ranged from 6 months to more than 2 years. The percentage of patients who were seizure free was 22% (29 of 130 patients) at 12-month follow-up, 28% (23 of 83) at 18-month follow-up, and 29% (12 of 42) at 24-month follow-up, Dr. Smith said.

Sedation, the most frequent levetiracetam side effect, occurred in 27% of the patients. Starting patients at 250 mg twice a day and titrating to 500 mg twice a day during the first few weeks of treatment appeared to reduce this effect, he said.

Dr. James Ferrendelli of the University of Texas Health Science Center, Houston, reported on a prospective phase IV trial involving 78 patients older than 65 with partial seizures. …

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