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[Paradoxical effect of levetiracetam on seizure suppression: three cases showing U curve association between dose and effect].
- Source :
-
Rinsho shinkeigaku = Clinical neurology [Rinsho Shinkeigaku] 2021 Apr 21; Vol. 61 (4), pp. 247-252. Date of Electronic Publication: 2021 Mar 25. - Publication Year :
- 2021
-
Abstract
- We experienced 3 adult patients with intractable focal epilepsy treated by levetiracetam (LEV) as polytherapy, who showed paradoxical effect (PE). Starting dose of LEV was small (62.5, 250 mg/day) and we gradually increased by less than 250 mg/day, every more than 2 weeks. Within 6 months after LEV was added, LEV of 750 to 1,000 mg/day brought reduction of seizure frequency. Serum concentration of LEV was 13.3 and 14.0 μg/ml. In order to obtain better seizure control, LEV was increased up to 1,000-2,500 mg/day (19.3-35.0 μg/ml) within one year, and they developed PE. They all showed increased habitual seizures, occurring in cluster. Once dose of LEV deceased down to what produced the maximum seizure suppression, all of the patients regained the better seizure control. It is most likely that at least in some patients like present 3 cases, PE of LEV may express U curve association between dose and effect and that it was only delineated by slow titration.
- Subjects :
- Adult
Anticonvulsants adverse effects
Dose-Response Relationship, Drug
Drug Therapy, Combination
Electroencephalography
Female
Humans
Levetiracetam adverse effects
Magnetic Resonance Imaging
Male
Seizures diagnosis
Treatment Outcome
Anticonvulsants administration & dosage
Levetiracetam administration & dosage
Seizures prevention & control
Subjects
Details
- Language :
- Japanese
- ISSN :
- 1882-0654
- Volume :
- 61
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Rinsho shinkeigaku = Clinical neurology
- Publication Type :
- Academic Journal
- Accession number :
- 33762498
- Full Text :
- https://doi.org/10.5692/clinicalneurol.cn-001553