Levetiracetam

Levetiracetam (INN) is an anticonvulsant medication used to treat epilepsy. It is the 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. Since November of 2008 the drug has been available as a generic brand in the United States.

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

Levetiracetam has been approved in the European Union as a monotherapy treatment for epilepsy in the case of partial seizures, or as an adjunctive therapy for partial, myoclonic and tonic-clonic seizures. 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, bipolar disorder and anxiety disorder, but its most serious adverse effects are behavioral and its benefit-risk ratio in these conditions is not well understood.

Mechanism of action
The exact mechanism by which levetiracetam acts to treat epilepsy is unknown. However, the drug binds to a synaptic vesicle protein, SV2A, which is believed to impede nerve conduction across synapses.

Side-effects
Levetiracetam is, in general, well tolerated but may cause drowsiness, weakness, unsteady walking, coordination problems, headache, pain, forgetfulness, anxiety, irritability or hostility, dizziness, moodiness, nervousness, loss of appetite, vomiting, diarrhea, constipation, and changes in skin color.

Some serious side effects can be depression, hallucinating (hearing voices or seeing visions that do not exist), suicidal thoughts, seizures that are worse or different, fever, sore throat, and other signs of infection, double vision, itching, rash, swelling of the face. A study published in 2005 suggests that the addition of pyridoxine (vitamin B6) may curtail some of the psychiatric symptoms.