Levetiracetam More Effective than Phenobarbital in Treating Seizures, Study Suggests

Levetiracetam More Effective than Phenobarbital in Treating Seizures, Study Suggests

Levetiracetam (marketed as Keppra), an anti-epileptic therapy, is significantly more effective than phenobarbital medication in infants with epilepsy, a recent study found, which could have implications for patients with Dravet syndrome.

In the study, “Comparative Effectiveness of Levetiracetam vs Phenobarbital for Infantile Epilepsy,” published in JAMA Pediatrics, scientists at Weill Cornell Medicine, NewYork-Presbyterian, and 16 other U.S. research institutions examined hospital records to see which therapy was more effective in treating infants with nonsyndromic epilepsy, the most common form of the disorder in patients from 1 month to 16 years old.

They found that levetiracetam was more effective than phenobarbital in treating the condition, results that may hold significance for a large percentage of infants who begin to have seizures in the first year of life.

Of the patients treated with levetiracetam, 40% did not have any more seizures within three months of the start of treatment, and did not require a second medication within six months, compared with only 16% in the phenobarbital group.

These results could also be relevant for Dravet syndrome patients, taking into account a Japanese case report that found that adding levetiracetam to the medication regimen of a patient with the disease stopped his seizures for more than a year.

The study, “Dramatic seizure reduction with levetiracetam in adult Dravet syndrome: a case report,” published in the Japanese journal J-Stage, described the case of a 28-year-old man who had been diagnosed with Dravet syndrome in childhood.

At the time of referral, the patient’s seizures were not responsive to medical treatment with monthly occurrences of tonic-clonic convulsions — a generalized seizure that affects the entire brain — despite administration of well-established seizure medicines including valproate (sold as Depakote), zonisamide (Zonegran), and clorazepate (Tranxene, among others).

Doctors added levetiracetam to the patient’s medication regimen when he was 29 years old, after which he remained seizure-free for more than a year.

“Levetiracetam was found to be effective in this adult patient as well as in a series of children affected with Dravet syndrome,” the authors said.

An anti-epileptic/anti-convulsant drug, levetiracetam is a seizure medicine widely used in combination with other anti-epileptic medications. Previous studies have found it to be effective in treating tonic-clonic seizures.

It is approved in many countries for seizure disorders, including as an add-on therapy for children 6 years and older and adults with generalized onset tonic-clonic seizures as a result of primary generalized epilepsy.

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