A Comparative Study to Evaluate the Efficacy and Safety of Levetiracetam as an Add-on to Carbamazepine and Phenytoin in Focal Seizures at a Tertiary Care Hospital
Praveen A N1, Praveen Panchaksharimath1*and Karthik Nagaraj2

1Department of Pharmacology, Bangalore Medical College and Research Institute (BMC and RI), Bengaluru, 560002, Karnataka, India

2Department of Neurology, Super speciality hospital (PMSSY) BMC and RI, Bengaluru 560002, Karnataka, India

Corresponding Author E-mail : praveengowdadr@yahoo.com

Abstract: Focal seizures account for 60% of all the epilepsies, 1/3rd of patients do not respond to monotherapy; making it necessary to try a combination of drugs for better seizure control. Levetiracetam has good safety profile, less drug interactions and no requirement of plasma monitoring making it a better adjunctive. To compare the efficacy and safety of levetiracetam as add-on to carbamazepine and phenytoin in treatment of focal seizures. Prospective, open label, comparative study conducted in the department of Neurology (PMSSY) from November 2016 to May 2018. 60 out-patients with focal seizures, already on phenytoin or Carbamazepine tablet were given Levetiracetam as add-on. Seizure count, adverse effects, and Quality of life (QOL) were monitored at 4th, 8th and 12th week. The mean age was 33.38 years and 63% were males. Levetiracetam as add-on had more than 50% reduction in seizure count from baseline in 90% and 100% of patients in Carbamazepine and phenytoin groups respectively. 66% in Carbamazepine group and 56% patients in Phenytoin group had no seizure episode during the course of treatment. Mild adverse effects like headache, giddiness, tiredness and slurring of speech were observed in both the groups. There was improvement in QOL in both the groups. However there were no significant differences in seizure count, QOL between groups across different time periods, when levetiracetam was used as add-on to both the drugs. Levetiracetam can be a better add-on to focal seizures patients who were not controlled with monotherapy.

Keywords: Carbamazepine; Focal Seizures; Levetiracetam; Phenytoin; Responder Rate

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