Efficacy and Safety of Levetiracetam and Carbamazepine as Monotherapy in Partial Seizures

Abstract

Introduction. Levetiracetam (LEV) is a newer antiepileptic drug with better pharmacokinetic profile. Currently, it is frequently used for the treatment of partial seizures. The present study was undertaken to compare the efficacy and safety of LEV and Carbamazepine (CBZ) in partial epilepsy. Methods. This was a prospective, open labeled, randomized study. It was conducted in participants suffering from partial seizures after the approval of ethics committee and written informed consent. The first group received Tab LEV (500 to 3000 mg/day) and the second group received Tab CBZ (300 to 600 mg/day). The primary outcomes were efficacy and safety. The secondary outcome was the Quality of Life (QOL). Efficacy was assessed by comparing the seizure freedom rates at the end of 6 months. Safety profile was evaluated by comparing the adverse effects. QOL was assessed by QOLIE-10 scale. Results. The overall seizure freedom rate at the end of 6 months was 71.42% in CBZ group compared to 78.57% in LEV group (p = 0.2529). Both LEV and CBZ reported a similar incidence of adverse reactions. LEV group reported more behavioral changes like increased aggression and anxiety. Also, it showed better QOL compared to the CBZ group. Conclusion. LEV monotherapy and CBZ monotherapy demonstrated similar efficacy for treatment of partial epilepsy and were found to be well tolerated.

Adverse effects of carbamazepine monotherapy among patients in Nigeria: a pilot study and implications

“…The rates of AEs in this study is similar to that reported by Suresh et al [25], and Fadare et al [10], who reported adverse effects rates of 36.6% and 37.6% respectively, although both studies used non-structured questionnaires. Other studies using adverse effect questionnaires have reported rates between 60-78% [6,26,27].…”

“…The high rates of memory impairment are similar to reports by Suresh et al and Eddy et al [25,30]. Whereas a study carried out in the south-south region of Nigeria did not report significant memory impairment in patients on AEDs [31].…”

“…Some studies included patients on carbamazepine therapy for a shorter period of time, polytherapy with sometimes with up to 3 AEDs, monotherapy with different AEDs and some included patients with drug resistant epilepsy [6,[25][26][27]29]. An earlier study in Nigeria, which reported adverse effects rates of 37.6%, had patients on therapy for a shorter duration of treatment, people on controlled release and immediate release formulations of carbamazepine and also included patients on polytherapy [10].…”

Evaluation of levetiracetam and valproic acid as monotherapy on quality of life in patients of generalized tonic clonic epilepsy

“…This result was supported by a study done by SS Hassan et al were the percentage change seen was 34.82%. 11 Subgroup analysis was also done in present study where different aspects of QOLIE-10 scores were compared which showed improvement in all spheres. The mean change in epilepsy effect (5.25±1.18), mental effects (5.39±1.20) and role function effects (7.44±1.42) ( Table 4).…”

Profile of serious adverse drug events in a tertiary care hospital of South India - a five years experience

“…15 An estimated 6-10 million people in India suffer from epilepsy which accounts for nearly 1/5 th of global epilepsy burden. 16 Higher number of ADEs is seen with Phenytoin, as it is one of the most frequently prescribed AED for seizure disorder because of its established efficacy since many years. Antiretroviral medications have also been associated with cutaneous ADE, ranging from mild exanthemas to lifethreatening reactions, such as SJS or TEN.…”