levetiracetam and Trigeminal-Neuralgia

To explore the efficacy and tolerability of levetiracetam in medical treatment of trigeminal neuralgia.. Antiepileptic drugs (AEDs) are considered as first-line treatment for trigeminal neuralgia, although their use is often limited due to incomplete efficacy and tolerability. Newer AEDs with improved safety profile may be useful in this disorder.. Patients suffering from trigeminal neuralgia (either primary or secondary) refractory to previous treatments were recruited to be treated with levetiracetam (3-4 g/day) for 16 weeks as add-on therapy, after a 2-week baseline period. Rescue medication was allowed in both the baseline and treatment phases. The primary efficacy measure was the number of attacks per day. The patients' efficacy evaluation, the patients' global evaluation for both safety and efficacy, changes in the Hamilton Depression Scale, the Hamilton Anxiety Scale, and the Quality of Life Measure Short Form-36 were secondary parameters.. Twenty-three patients were included in the analysis. After treatment and compared to the baseline phase, the number of daily attacks decreased by 62.4%. All secondary parameters changed significantly with the exception of the Quality of Life Measure Short Form-36 score. Seven patients withdrew from the study. Five patients (21.7%) reported side effects and 2 withdrew.. Levetiracetam may be effective and safe in trigeminal neuralgia treatment. Confirmation in a randomized controlled study is needed.

Topics: Adolescent; Adult; Aged; Anticonvulsants; Female; Humans; Levetiracetam; Male; Middle Aged; Pilot Projects; Piracetam; Prospective Studies; Treatment Outcome; Trigeminal Neuralgia; Young Adult

The objective of this study was to determine whether levetiracetam (LEV) is an effective drug for treatment of trigeminal neuralgia (TN).. Ten patients with TN were enrolled in a 10-week, prospective, open-label pilot study. The primary outcome measure was the visual analogue scale on daily pain diary and side effects. Serum levels of LEV were measured to assess correlation between drug levels and pain control.. There was a significant tendency towards improvement in pain severity compared with baseline in four patients with higher doses of 4,000 mg/day. The four treatment responders had less pain compared with baseline (50-90% improvement) and three subjects continued the drug after study completion. All patients rated themselves on the global evaluation scale as much improved (n = 2), minimally improved (n = 3), no change (n = 1), minimally worse (n = 2), much worse (n = 1) and very much worse (n = 1). LEV was very well tolerated and there was no difference in side effects between the low and high doses of LEV evaluations.. Given its established safety profile, a randomized, placebo-controlled, double-blind trial of LEV using enhancement enrollment design is needed to confirm these open-labelled findings using a wide variety of outcome measures.

Topics: Aged; Aged, 80 and over; Anticonvulsants; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Resistance; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Levetiracetam; Male; Middle Aged; Pain Measurement; Patient Satisfaction; Pilot Projects; Piracetam; Prospective Studies; Treatment Outcome; Trigeminal Neuralgia