Levetiracetam adjunctive therapy

Levetiracetam As adjunctive therapy in treatment of partial onset seizures in adults with epilepsy. 

Shorvon SD, Van Rijckevorsel K, Verdru P. Pooled efficacy and safety data of levetiracetam (LEV) used as adjunctive therapy in patients with partial onset seizures. Epilepsia 1999 40(Suppl 7) 76. 

Levetiracetam (Keppra) is approved for adjunctive therapy and treatment of partial onset seizures in adults with epilepsy. Levetiracetam is 100% bioavaflable. Once absorbed, it is <10% bound to protein and has a volume of distribution of 1.0 L/kg. Following an oral dose, it reaches maximum... 

Perucca E, Gidal BE. Effects of anti epileptic comedication on levetiracetam pharmacokinetics A pooled analysis of data, from randomized adjunctive therapy trials. Epilepsy Res 2003 53 47-56. 

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. 

Levetiracetam " (LEV) is FDA approved for the treatment of adjunctive therapy in adults in partial seiznres. 

In 152 children in an open, long-term study of levetiracetam as adjunctive therapy for partial-onset seizures the mean maintenance dose was 56 mg/kg/day and the median treatment duration was 287 days [204 ]. At least one adverse event was reported in 143 patients (94%) the most common were convulsions (25/152 16%), irritability (19/152 13%), and somnolence (16/152 11%). 

In a retrospective study in 218 patients, mostly adults, with localization-related epilepsy, taking levetiracetam as adjunctive therapy or monotherapy for up to 36 months, the retention rates at 6, 12, 24 and 36 months after the start of levetiracetam treatment were 92%, 75%, 60%, and 54% respectively [205 ]. 

Kwan P, Lim SH, Chinvarun Y, Cabral-Lim L, Aziz ZA, Lo YK, Tonner F, Beh K, Edrich P N01036 (SKATE II) Investigator Group. Efficacy and safety of levetiracetam as adjunctive therapy in adult patients with uncontrolled partial... 

Placebo-controlled studies The effect of levetiracetam as adjunctive therapy in Chinese patients with refractory partial seizures has been evaluated in a 4-week titration and 12-week maintenance period, randomized, placebo-controlled trial in 56 patients [183. There were adverse events in 23 patients taking levetiracetam and 22 taking placebo. These were generally moderate and no patient withdrew. Levetiracetam was associated with somnolence, dizziness, and agitation in more than 10% of patients. There were no treatment-emergent serious adverse events. 

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. 

I Place in Therapy. Currently, levetiracetam is indicated for patients with partial seizures who have failed initial therapy. Its role as monotherapy for partial seizures and as adjunctive treatment for generalized seizures remains to be clarified. 

Lee YJ, Kang HC, Kim HD, Lee JS. Efficacy and safety of adjunctive levetiracetam therapy in pediatric intractable epilepsy. Pediatr Neurol 2010 42(2) 86-92. 

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