A cross-sectional comparative study to evaluate the efficacy and safety of levetiracetam with other antiepileptics among epileptic patients at a tertiary care teaching hospital

Background: Epilepsy is a neurological disorder characterized by recurrent seizures, and about one-third of patients do not respond to a single antiepileptic drug (AED). Levetiracetam (LEV) is commonly used as a first-line treatment for partial seizures and in combination with other AEDs. This study aimed to determine which combination therapy with LEV is more effective and safer for treating focal epilepsy.

Method: The study analyzed 90 patients diagnosed with focal epilepsy, who were treated with LEV in combination with other AEDs. The efficacy was assessed by comparing the seizure count before and after combination therapy, and safety was evaluated based on adverse effects. Statistical analysis was performed using IBM SPSS 22.0.

Result: There were five groups in which levetiracetam was used in combination with other AED 

• Group A: Levetiracetam + Lacosamide
• Group B: Levetiracetam + Clobazam
• Group C: Levetiracetam + Oxcarbazepine
• Group D: Levetiracetam + Sodium valproate
• Group E: Levetiracetam + Phenytoin

Due to an insufficient sample size, only Group A (LEV-LCM) and Group B (LEV-CLB) were statistically analyzed. The t-values for these groups were 15.132 and 13.889, respectively, both statistically significant with a p-value <0.001.

Conclusion: The results from this study showed that the addition of a second AED significantly reduced the seizure count when compared with a single AED regimen. LEV-LCM & LEV-CLB combination were taken for the analysis of safety and efficacy. It was found that there was a significant difference in seizure count within the groups with a p value <0.001. Comparing the t test value, it was found that the addition of LCM to LEV produce a greater difference in seizure count. Only a few minor side effects were observed in both the groups