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Levetiracetam
Systematic (IUPAC) name
(S)-2-(2-oxopyrrolidin-1-yl)butanamide
Identifiers
CAS number 102767-28-2
ATC code N03AX14
PubChem 441341
ChemSpider 4447633
Chemical data
Formula C8H14N2O2 
Mol. mass 170.209 g/mol
SMILES eMolecules & PubChem
Pharmacokinetic data
Bioavailability ~100%
Protein binding <10%
Metabolism Enzymatic hydrolysis of acetamide group
Half life 6 - 8 hr
Excretion Urinary
Therapeutic considerations
Pregnancy cat. C(US)
Legal status Prescription only
Routes Oral, intravenous
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Levetiracetam (INN) (pronounced /lɛvɨtɪˈræsɨtæm/) is an anticonvulsant medication used to treat epilepsy.[1] It is S-enantiomer of etiracetam, structurally similar to the prototypical nootropic drug piracetam.

Levetiracetam is marketed under the trade name Keppra. Keppra is manufactured by UCB Pharmaceuticals Inc.

Contents

Uses

Along with other anticonvulsants like gabapentin, it is also sometimes used to treat neuropathic pain.

Levetiracetam has recently been approved in the United Kingdom as a monotherapy treatment for epilepsy. It is also used in veterinary medicine for similar purposes.

Levetiracetam has potential benefits for other psychiatric and neurologic conditions such as Tourette syndrome, autism, and anxiety disorder, but its most serious adverse effects are behavioral and its benefit-risk ratio in these conditions is not well understood.[2]

Mechanism

The exact mechanism for Levetiracetam is unknown. However, the drug binds to a synaptic vesicle protein, SV2A,[3] which is believed to impede nerve conduction across synapses.[4]

Side effects

Side effects include: hair loss; pins and needles sensation in the extremities; anxiety and psychiatric symptoms ranging from irritability to depression; and other common side effects like headache and nausea. Recent literature[5] suggests that the addition of pyridoxine (vitamin B6) may curtail some of the psychiatric symptoms.

Levetiracetam is generally well tolerated[6] but may cause sleepiness, weakness, dizziness, and infection. In children, the most common side effects are sleepiness, accidental injury, hostility, irritability, and weakness. [7]

References

  1. ^ Abou-Khalil B (June 2008). "Levetiracetam in the treatment of epilepsy". Neuropsychiatr Dis Treat 4 (3): 507–23. PMID 18830435. 
  2. ^ Farooq MU, Bhatt A, Majid A, Gupta R, Khasnis A, Kassab MY (2009). "Levetiracetam for managing neurologic and psychiatric disorders". Am J Health Syst Pharm 66 (6): 541–61. doi:10.2146/ajhp070607. PMID 19265183. 
  3. ^ Lynch BA, Lambeng N, Nocka K, et al. (June 2004). "The synaptic vesicle protein SV2A is the binding site for the antiepileptic drug levetiracetam". Proc Natl Acad Sci USA. 101 (26): 9861–6. doi:10.1073/pnas.0308208101. PMID 15210974. 
  4. ^ Rogawski, MA (June 2006). "Diverse mechanisms of antiepileptic drugs in the development pipeline". Epilepsy Research 69 (3): 273–94. doi:10.1016/j.eplepsyres.2006.02.004. PMID 16621450. 
  5. ^ "Clinical Epilepsy: Pediatrics". Epilepsia 46 (s8): 142–67. 2005. doi:10.1111/j.1528-1167.2005.460801_16.x. http://www3.interscience.wiley.com/journal/118734483/abstract. 
  6. ^ Gambardella A, Labate A, Colosimo E, Ambrosio R, Quattrone A (February 2008). "Monotherapy for partial epilepsy: focus on levetiracetam". Neuropsychiatr Dis Treat 4 (1): 33–8. PMID 18728811. 
  7. ^ "Epilepsy, Seizure Treatment, and Epileptic Seizures: Keppra (levetiracetam) Homepage - www.Keppra.come". http://www.keppra.com/pc/home/default.asp. Retrieved 2008-12-14. 

External links

See also








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