#Valproate (VPT) is still more efficacious and more cost-effective as compared to #levetiracetam (LEV) for treating generalized #Epilepsy (GE)
1. I see an increasing trend for prescribing LEV in emergency room, ICU & OPD for GE
#MedTwitter #neurotwitter
doi.org
1. I see an increasing trend for prescribing LEV in emergency room, ICU & OPD for GE
#MedTwitter #neurotwitter
doi.org
2. In a recent study, LEV was found to be inferior for times to treatment failure, 2-year remission from seizures, and first subsequent seizure. In addition, LEV was not found to be a cost-effective alternative.
3. This is despite the fact the LEV is associated with a higher incidence of #psychiatric and #behavioral adverse effects.
This is a major problem in #ICU patients, as it adds to the burden of patients with #psychosis in ICU.
This is a major problem in #ICU patients, as it adds to the burden of patients with #psychosis in ICU.
4. In women of child-bearing age, there is an increased risk of teratogenicity with VPT, however, studies indicate that lower dose (upto 600 mg/day) can be safe and effective. In any case, discussion regarding safety and efficacy of VPT vs LEV is needed in this group of patients.
5. Take home message:
VPT is the drug of choice for treating idiopathic generalized epilepsy.
LEV can be offered, if VPT is contraindicated (as in pregnant women) or in medically-refractory epilepsy cases.
VPT is the drug of choice for treating idiopathic generalized epilepsy.
LEV can be offered, if VPT is contraindicated (as in pregnant women) or in medically-refractory epilepsy cases.
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