Levetiracetam versus Carbamazepine as Monotherapy for Treating Partial Seizures

12 Jun, 20

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Background

Carbamazepine is the preferred drug for the treatment of partial seizures; but frequent dosing, dose related adverse reactions and drug interactions are the major disadvantages associated with it. Levetiracetam is a newer drug for partial seizures and has several advantages over carbamazepine. These include; twice daily dosing, better safety profile, lesser drug interactions and no requirements of serum level monitoring. Not many studies have compared the efficacy and safety of levetiracetam and carbamazepine as monotherapy for treating partial seizures.

Aim

To compare the efficacy and safety of levetiracetam and carbamazepine as monotherapy in partial epilepsy

Patient Profile

Patients with newly diagnosed partial seizures (age; 18-60 years, n=60)
Patients with intracranial hemorrhage, trauma, brain infection, liver or kidney failure, very high blood pressure, use of illegal drugs, cerebrovascular accidents presenting with partial seizures were all included in the study.

Methods

Study Design

Prospective, comparative, randomized, open labeled study conducted in tertiary care hospital in India

Treatment Strategy

Outcomes

Seizure freedom
Adverse effects
Quality of life assessed using Quality Of Life In Epilepsy (QOLIE-10) questionnaire

Treatment Duration

12 weeks

Follow-up Visits

End of Week 4 and week 12

Results

There was no statistically significant difference in the proportion of seizure-free patients in both the groups at week 4 and week 12 (Table 1).

Table 1: Proportion of seizure-free patients in the study groups

Duration	LEV (%)	CBZ (%)	P value
4 weeks	90.00	73.33	>0.05
12 weeks	96.67	80.00	>0.05

The overall incidence of adverse effects did not differ significantly in the two study groups (30% vs. 33.33%; p>0.05).
Patients treated with levetiracetam had a significantly greater improvement in quality of life at week 4 and week 12 (Table 2).

Table 2: QOLIE-10 questionnaire score in study groups

Duration	LEV group	CBZ group	P value
0 week	27.93	30.60	>0.05
4 weeks	51.73	41.70	<0.05
12 weeks	64.50	57.13	<0.05

Conclusions

Levetiracetam was comparable to carbamazepine in terms of efficacy and safety for treating partial seizures.
Patients treated with levetiracetam had a greater improvement in quality of life at 12 weeks as compared to those treated with carbamazepine.
Levetiracetam can be considered as a better option against carbamazepine for treating partial seizures.

Int J Sci Res. 2019;8(11): 54-5.

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