J Clin Neurol.  2019 Apr;15(2):149-151. 10.3988/jcn.2019.15.2.149.

Short-Term and Long-Term Effects of Levetiracetam Monotherapy on Homocysteine Metabolism in Children with Epilepsy: A Prospective Study

• Attilakos
• Paschalidou M
• Garoufi A
• Tsirouda M
• Papadopoulou A
• Karalexi M
• Dinopoulos A

• KMID: 2467727
• DOI: http://doi.org/10.3988/jcn.2019.15.2.149

Abstract

BACKGROUND AND PURPOSE
Long-term treatment with some older antiepileptic drugs may lead to hyperhomocysteinemia. Levetiracetam (LEV) is a newer broad-spectrum antiepileptic agent whose effects on homocysteine concentrations remain unclear. The purpose of this study was to prospectively determine the short-term and long-term effects of LEV monotherapy on homocysteine metabolism in children with epilepsy.
METHODS
The study population consisted of 32 children [18 females, 14 males; age 5.94±4.10 years (mean±SD), age range 1-15 years] who received LEV monotherapy for new-onset epilepsy. Serum folate, serum vitamin B12, and plasma total homocysteine (p-tHcy) were measured before and at 2 months (n=32), 6 months (n=25), and 12 months (n=18) of LEV monotherapy.
RESULTS
p-tHcy was significantly decreased at 2 months of treatment (p=0.031). Furthermore, analysis of covariance showed statistically significant decreases in p-tHcy at 2 months (p=0.013) and 6 months (p=0.015) of LEV treatment after controlling for age, sex, body mass index, and LEV dose. There were no significant alterations in the other parameters during the study. The drug doses were 18.1±7.1, 20.1±9.2, and 21.2±11.8 mg/kg at 2, 6, and 12 months of LEV treatment, respectively.
CONCLUSIONS
In contrast with older antiepileptic drugs, long-term LEV monotherapy in children with epilepsy does not cause adverse alterations on homocysteine metabolism. Larger prospective studies are needed to definitively clarify whether LEV may be considered a safer alternative drug for preventing antiepileptic-drug-induced cardiovascular complications in adult life.

Keyword

children; epilepsy; homocysteine; levetiracetam

MeSH Terms

Adult
Anticonvulsants
Body Mass Index
Child*
Epilepsy*
Female
Folic Acid
Homocysteine*
Humans
Hyperhomocysteinemia
Male
Metabolism*
Plasma
Prospective Studies*
Vitamin B 12
Anticonvulsants
Folic Acid
Homocysteine
Vitamin B 12

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