Medicine & USMLE

Levetiracetam

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Antiepileptics
  1. Valproic Acid (Valproate)
  2. Carbamazepine
  3. Ethosuximide
  4. Gabapentin
  5. Lamotrigine
  6. Levetiracetam
  7. Barbituates (Phenobarbital, Thiopental)
  8. Topiramate
  9. Vigabatrin

Summary

Levetiracetam is a broad spectrum antiepileptic used to treat various types of seizures, including focal and generalized seizures. Although it’s mechanism is poorly understood, levetiracetam is effective for treating seizures, and only has minor side effects like fatigue, drowsiness, and headaches. In general, levetiracetam's favorable side effect profile makes it one of the most commonly prescribed antiepileptics.

Key Points

  • Levetiracetam
    • Mechanism
      • Unknown; may modulate GABA and glutamate release, inhibits voltage-gated Ca+ channels
      • Binds to synaptic vesicle protein SV2A, which may modulate synaptic transmission by altering vesicle fusion
    • Clinical Use
      • Broad spectrum antiepileptic (1st line)
        • Treats partial (focal) seizures, generalized (tonic-clonic) seizures
    • Adverse Effects
      • Relatively few side effects
        • Popular in the hospital (and 1st-line in chronic seizure management) due to its relatively safety among the antiepileptics
      • Neuropsychiatric symptoms (e.g. personality changes), fatigue, drowsiness, headache may be seen