Drowsiness levetiracetam

Specific myoclonic syndromes are usually treated with valproate an intravenous formulation can be used acutely if needed. It is nonsedating and can be dramatically effective. Other patients respond to clonazepam, nitrazepam, or other benzodiazepines, although high doses may be necessary, with accompanying drowsiness. Zonisamide and levetiracetam may be useful. Another specific myoclonic syndrome, juvenile myoclonic epilepsy, can be aggravated by phenytoin or carbamazepine valproate is the drug of choice followed by lamotrigine and topiramate. 

Levetiracetam acts in a manner different to other antiepilepsy drugs. It has a potentially broad spectrum of use but is currently indicated for adjunctive treatment in partial seizures with or without secondary generalisation. It is rapidly and completely absorbed after oral administration, and is effective with twice-daily dosing. Its therapeutic index appears to be high and the commonest of the adverse effects are asthenia, dizziness and drowsiness. 

Observational studies Levetiracetam monotherapy has been investigated in 35 patients with late-onset post-stroke seizures in a prospective open study [178 ]. At a mean follow-up period of 18 months, 27 patients had achieved seizure freedom. Four of 35 patients stopped taking levetiracetam because of severe adverse events drowsiness with gait disturbance and aggressive behavior in two cases, and severe psychomotor agitation with aggressive behavior in the other two patients. 

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