Exacerbation of Seizures - Any Relationship To Dose Escalation of Levetiracetam ( Keppra[tm])?
Abstract number :
2.259
Submission category :
Year :
2001
Submission ID :
3112
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
G.D. Montouris, MD, The Comprehensive Epilepsy Care Center, St. Louis, MO; S.M. Lippmann, MD, The Comprehensive Epilepsy Care Center, St. Louis, MO; W.E. Rosenfeld, MD, The Comprehensive Epilepsy Care Center, St. Louis, MO; PADS Group
RATIONALE: Clinical trials of levetiracetam ( Keppra[tm]) as add-on therapy in the treatment of partial seizures with or without secondary generalization have shown significant efficacy at doses ranging from 1000-3000mg/day. Limited data at doses above 3000mg/day as well as efficacy in generalized seizure syndromes( Lennox-Gastaut) exist at this time.
METHODS: We reviewed efficacy data in 47 patients at our center, treated with levetiracetam as add-on therapy. Seizure types included partial seizures with or without secondary generalization, generalized seizure disorders as well as Lennox-Gastaut syndrome.
RESULTS: Five patients initially demonstrating a significant response to the addition of levetiracetam, experienced a marked increase in seizure activity upon dose escalation. Generalized seizures were affected the most. Doses of 3000mg/day to 4500mg/day were administered in 4 of the 5 patients. Only one patient showed a marked exacerbation of seizures at 1750mg/day. In each case, lowering the dose, resolved the exacerbation.
CONCLUSIONS: Exacerbation of seizure activity may occur in a small number of patients with escalating doses of levetiracetam. Decreasing the dosage to the previously most effective dose improved the outcome. Analysis of the PADS data suggests our findings are not unique. Our findings suggest with appropriate dose adjustment, efficacy can be achieved and that discontinuation of levetiracetem is not necessarily warranted.
Disclosure: Grant - UCB Pharma investigational drug trials; Honoraria - UCB Pharma