• B S Mathew, D H Fleming, M Thomas, R Prabha, and K Saravanakumar.
• Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India. clinpharm@cmcvellore.ac.in
• Neurol India. 2012 Mar 1; 60 (2): 146-9.

Background And ObjectivesMonitoring of levetiracetam in routine clinical practice is not strongly recommended. The aim of this study was to investigate any difference in serum levetiracetam concentration between patients on enzyme-inducing and -inhibiting antiepileptic co-medication and also to identify any correlation between levetiracetam concentration and clinical response.Materials And MethodsThis study included pediatric patients with epilepsy from a tertiary care referral hospital in India. Details of antiepileptic co-medication, seizure frequency before and after initiating levetiracetam were recorded. Serum trough levetiracetam concentration was measured.ResultsOf the 69 children recruited in the study, 55 children had >50% reduction in seizure frequency compared to baseline seizure frequency. Eight patients showed no improvement. The serum concentration of levetiracetam was more than 10 μg/ml in 78.2% of responders and 75% non-responders. There was no difference in dosing between responders and non-responders. Patients on enzyme-inducing co-medication had lower median serum levetiracetam concentrations (7.3 μg/ml) compared to those on enzyme-inhibiting co-medication (14.4 μg/ml) or those without interfering antiepileptic co-medication (16.6 μg/ml).ConclusionLevetiracetam monitoring has a role in patients on antiepileptic polypharmacy and for confirmation of compliance.

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