Keppra (levetiracetam) is an oral anticonvulsant developed by UCB that can be used to prevent seizures in people with Batten disease. It often is the first medication used to achieve seizure control in juvenile Batten disease patients. Keppra cannot stop a seizure that has already started.
How Keppra works
Under normal circumstances, the brain relays information from one area to another via the nerve cells firing electrical impulses. Seizures happen when there is a sudden, rapid increase in electrical activity in the brain.
Precisely how Keppra works to prevent seizures is not fully understood, but it is thought to possibly “calm the brain” by preventing nerve cells from becoming hyperactive and to do so without affecting normal electrical impulses.
Keppra in clinical trials
No clinical trials have assessed the effectiveness of Keppra specifically in Batten disease patients. However, the medicine is frequently used to treat partial seizures, which can arise in people with this disease. These types of seizures begin on one side of the brain and can cause motor symptoms such as jerking limbs on one side, or non-motor symptoms, such as changes in vision, sense of smell, and hearing.
A double-blind, placebo-controlled study conducted by the European Levetiracetam Study Group evaluated the safety and effectiveness of Keppra in managing refractory partial seizures.
The study found that patients who experienced reductions in their seizure frequency after taking Keppra, in addition to an existing anticonvulsant, were able to sustain good seizure control when gradually switched from taking both medications to just taking Keppra alone in doses of 1,500 mg twice a day.
A multicenter, double-blind, randomized placebo-controlled clinical trial (NCT00175890) found that Keppra was effective as an add-on therapy in children, ages one month to less than four years who had partial-onset seizures. Keppra was able to reduce seizure frequency by 43.6% compared to the 7.1% reduction seen in the placebo group. Keppra was well-tolerated, with the most common side effects being drowsiness and irritability.
A retrospective study looking at 231 children with epilepsy found that Keppra was able to reduce seizure occurrence by more than 90% in 65% of the participants. About 17% of those patients reported side effects that included irritability, hyperactivity, drowsiness, restlessness, and behavioral disorders. The researchers noted that while this study confirmed the effectiveness of Keppra as initial monotherapy for different types of seizures and/or epilepsy syndromes, they stressed that more trials were necessary for children with specific epilepsy syndromes.
More details about Keppra
Keppra is approved by the U.S. Food and Drug Administration (FDA) to treat partial seizures in adults and children, age four and older. It also can be used to treat myoclonic seizures in patients 12 and older, and to treat generalized tonic-clonic seizures in adults and children six and older.
As with any other anticonvulsant, Keppra should be taken consistently without missing a dose, even if patients have not been experiencing seizures. It should not be stopped abruptly; it should be gradually tapered off.
The most common side effects of Keppra include weakness, drowsiness, sleepiness, and an increased risk of infection. Children may be more prone to accidental injuries, hostility, and irritability. While these side effects can happen anytime, they are more likely to occur within the first month of treatment.
Some people may experience suicidal thoughts when starting this medication. It is important to be aware of mood changes and to inform the attending physician if the patient has had a history of mental illnesses.
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