Abstracts

Rationale: Levetiracetam (LEV) was released as anti-epileptic drug (AED) in North America around 2000. In Japan, LEV was available through October 2010 as adjunctive therapy for localized-related epilepsy. We evaluated safety and efficacy of LEV as an AED in our hospital database from the release. Methods: The record of 132 patients aged ≥16years receiving LEV as an AED for epilepsy were retrospectively evaluated with respect to classification of epilepsy, seizure outcome, adverse events and discontinuation of LEV. The rate of the adverse event and discontinuation of LEV according to starting dose (1000mg/day or less) were also evaluated in 126 patients of them. Results: The populations were constituted of localization-related epilepsy (n=112) and generalized epilepsy (n=19). Compared with pretreatment baseline, 53.6% of patients with localization-related epilepsy reduced ≥50% in seizure frequency and 28.6% of them became seizure free during the treatment period. In generalized epilepsy, 4 of 6 patients with idiopathic generalized epilepsy and 2 of 13 patients with symptomatic generalized epilepsy had a ≥50% reduction in seizure frequency. Adverse events were reported in 27.3% of patients and caused discontinuation of LEV in 10.6%. The most frequent adverse events were somnolence (14.4%), irritability or aggressiveness (6.1%) and depression (4.5%). In 67 patients of standard starting dose, 15 patients (22.4%) had adverse events and 8 patients (11.9%) discontinued. In 59 patients of lower starting dose (<1000mg/day), 20 patients (33.8%) had adverse events and 17 patients (28.8%) discontinued. Conclusions: LEV was well tolerated and efficacious as an adjunctive therapy for localization-related epilepsy and idiopathic generalized epilepsy. However, LEV was not so effective for symptomatic generalized epilepsy. The frequency of adverse events and discontinuation rate after LEV treatment was irrelevant to its starting dose.