Abstracts

To evaluate the safety and efficacy of Levetiracetam (LEV) at 6 months and 1 year of treatment in idiopathic generalized and localization related epilepsy. We analyzed the majority of cases started on LEV from tertiary care adult epilepsy centre. Epilepsy classification, concomitant AEDs, titration, retention, treatment duration, reasons for discontinuation, maintenance doses, adverse effects and responses were analyzed. The primary end points were seizure freedom at 6 and 12 months, greater or = 50% responder rate or less than 50%, discontinuation of LEV, adverse effects, lack of efficacy or both. Seventy males and 67 females, mean age 36.7 years, the majority (119/137) with partial or generalized, cryptogenic/symptomatic and 19 idiopathic generalized epilepsy, were treated. All patients were followed for a mean of 12 months. Titration was slow ([le]500mg/day/week) in 76 and [ge]500mg b.i.d. in 61. LEV was discontinued in 41(30%) due to side effects. Fatigue (17/137), dizziness (9/137) and drowsiness (9/137) were the most common adverse effects. Behavioral adverse effects (BAE) occurred in 16% (22/137). Depression (3.6%), aggression (3.6%) and emotional lability (3.0%) were the commonest BAE. BAE was the most common reason for LEV discontinuation. At one year or later 56% (45/88) had [gt]/ = 50% seizure improvement. Withdrawal to monotherapy was successful in 5% (7/137). In the same cohort 19% (17/88) at 6 months and 24% (21/88) at one year or[gt] were seizure free. LEV is effective not only as adjunctive therapy in refractory localization related but also idiopathic generalized epilepsies. LEV was withdrawn in 30% because of adverse effects. Although sedation was the commonest adverse effect, BAE was more likely reason for discontinuation. A significant number of patients in the cohort were seizure free at six and 12 months respectively.