Levetiracetam anticonvulsant

Loscher W, Honack D, Rundfeldt C. Antiepileptogenic effects of the novel anticonvulsant levetiracetam (ucb L059) in the kindling model of temporal lobe epilepsy. J Pharm Exp Ther 1998 284 474 79. 

A double-blind study of the anticonvulsant levetiracetam in 20 autistic children and adolescents failed to detect a significant difference between levetiracetam and placebo with respect to global improvement (CGI) or measures of repetitive behaviors (Children s Y-BOC) and/or hyperactivity (Conners Rating Scales-Revised) (Wasserman et al., 2006). 

Mitchell JM, Grossman LE, Coker AR, Messing RO. The anticonvulsant levetiracetam potentiates alcohol consumption in non-treatment seeking alcohol abusers. J Clin Psychopharmacol April 2012 32(2) 269-72. 

Atypical antipsychotics and anticonvulsants such as valproate may be safer than levetiracetam during the postpartum period when breast feeding... 

Bromide (1857) was the first drug to be used for the treatment of epilepsy, but it is now obsolete. Phenobarbital, introduced in 1912, controlled patients resistant to bromides. The next success was the discovery in 1938 of phenytoin (a hydantoin) which is structurally related to the barbiturates. Since then many other drugs have been discovered, but phenytoin still remains a drug of choice in the treatment of major epilepsy. Over the past ten years there has been a dramatic increase in the number of new anticonvulsant drugs (vigabatrin, gabapentin, lamotrigine, topiramate, oxcarbazepine, levetiracetam), but none has been shown to be superior to the major standard anticonvulsants (phenytoin, carbamazepine and sodium valproate). 

Schachter SC. The next wave of anticonvulsants focus on levetiracetam, oxcarbazepine and zonisamide. CNS Drugs 2000 14 229 9. 

Levetiracetam. Levetiracetam is a new anticonvulsant agent that does not as yet present any drug interactions. Dizziness and somnolence occurred to a statistically significant extent (14.8% versus 8.4% of the placebo patients) (18). This side effect occurred more frequently with patients receiving levetiracetam in combination with other anticonvulsant agents. 

A review of the second-generation anticonvulsants reveals that screening or serendipity led to the development of felbamate (10), 1am-otrigine (11), zonisamide (13), topiramate (15), and levetiracetam (16) on the other hand, clobazam (4d) and oxcarbazepine (12) were developed by structural variation of known agents (78). Only three, vigabatrin (8), gabapentin (9), and tiagabine (14), were developed by mechanism-based rational development (78). 

Newer anticonvulsants such as levetiracetam and zonisamide have several published case reports or open trials showing efficacy in mania and treatment-refractory rapid cycling, but it is too early to predict whether they have a place in either acute or maintenance... 

The place in therapy of the newer anticonvulsants, such as gabapentin, levetiracetam, tiagabine, topiramate, and zon-isamide, is controversial. Many clinicians consider these agents to be less effective than established mood stabilizers based on initial studies and avoid them for monotherapy in bipolar disorder. 

Levetiracetam is an anticonvulsant that selectively prevents hypersynchronization of epileptiform bnrst firing and propagation of seiznre activity. It is indicated as an adjunctive therapy in partial onset seizures in adnlts with epilepsy. 

Piracetam 3 [60a] is medicinally used as anticonvulsant and antiepileptic. Levetiracetam 4 is a chiral second-generation analogue of 3 providing a useful alternative for adjunctive therapy to conventionally anticonvulsants, e.g. benzodiazepines. 

A method for the analysis of the basic antiepileptic compounds felbamate, lamotrigine, carbamazepine, carbamazepine-10,11-epoxide, gabapentin, pregabalin, levetiracetam, and oxcarbazepine monohydroxy derivative (oxcarb MHD) in human plasma is described. This protocol incorporates a simplified sample preparation step followed by quantitative high performance chromatography-tandem mass spectrometry detection of commonly prescribed and monitored anticonvulsant drugs. Since polytherapy is common in epilepsy patients, use of a multiconstituent assay can improve laboratory efficiency and reduce required analytical time. 

Commercial immunoassays have long been available for the classic anticonvulsants such as phenytoin, carbamazepine, valproic acid, primidone, and ethosuximide and generally provide useful results under normal TDM conditions. Kits for the newer anticonvulsants such as lamotrigine, gabapentin, zonisamide, and levetiracetam have become available only recently so their effectiveness in monitoring in a broad population cannot yet be evaluated. While targeted immunoassay can be a very efficient and cost-effective way... 

Piracetam (16) [236] is medicinally used as an anticonvulsant and antiepileptic. Levetiracetam (17) is a chiral second-generation analog of 16 providing a useful alternative adjunctive therapy to be used alongside conventional anticonvulsants, for example, benzodiazepines. 

A prospective study evaluated the safety and efficacy of levetiracetam for perioperative anticonvulsive therapy of patients with suspected brain tumors undergoing neurosuigery [89 ]. Thirty patients received levetiracetam 500 mg twice daily for 72 h, after which the dose was increased to 1000 mg twice daily. Two of the 30 patients had adverse events potentially attributable to the medication. One developed paresthesias and a visual field defect. The other also... 

Alkhotani A, McLachlan RS. Levetiracetam induced angioedema in a patient with previous anticonvulsant hypersensitivity reaction to phenytoin and lamotrigine. Seizure June 2012 21(5) 407-8. 

Myhrer, T., Enger, S., Jonassen, M., et al., 2011. Enhanced efficacy of anticonvulsants when combined with levetiracetam in soman-exposed rats. Neurotoxicology 32, 923-930. 

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