Abstract
Phenytoin and levetiracetam are both antiepileptic drugs (AEDs) used for seizure prophylaxis. However, to date, there is a paucity of literature comparing their relative efficacies. In this narrative review, we seek to determine if there is greater advantage between the two AEDs, levetiracetam and phenytoin. Phenytoin is the more traditional AED of the two as it has been medically used for a much longer time than levetiracetam. However, levetiracetam, the newer AED of the two, has fewer side effects than phenytoin and fewer drug-drug interactions. Although past studies have aimed to compare the efficacy of phenytoin versus levetiracetam, there is no clear consensus as to if there is a clinical advantage to one over the other. Here, we have analyzed several studies published between 2013 and 2020 in the hopes of having a better understanding of which AED is more efficient in preventing seizures. Many factors can contribute to determining which AED is the better fit for patients, including pricing, risk for adverse drug effects, and level of patient monitoring. After analysis of past research, the more advantageous AED still remains unclear. Future research must be conducted that involve large patient populations, stratifying age populations, and studies analyzing cost-effectiveness to clearly determine if there is indeed a more advantageous AED between levetiracetam and phenytoin.
Highlights
BackgroundLevetiracetam and phenytoin are two of the most commonly used antiepileptic drugs (AEDs) in seizure prevention
Prolonged seizures that may occur after traumatic brain injury (TBI), intracranial hemorrhage, or neoplastic augmentation of cortical fibers are capable of causing permanent neurological deficits by causing neuronal cell death
Testing the efficacy of levetiracetam versus phenytoin across different age populations may be a future experimental design. When it comes to clinical practice, levetiracetam and phenytoin are both reliable AEDs for treating seizures; the level of patient monitoring, risk for adverse drug effects, and pricing should be considered when treatment is administered
Summary
Brian Fiani 1 , Christopher Andraos 2 , Iveth Mabry 3 , Javed Siddiqi 1, 4, 5, 6. 1. Neurosurgery, Desert Regional Medical Center, Palm Springs, USA 2. College of Natural and Agricultural Sciences, University of California Riverside, Riverside, USA 3. Arrowhead Regional Medical Center, Colton, USA 4. Neurosurgery, Riverside University Health System Medical Center, Moreno Valley, USA 5. Neurosurgery, Arrowhead Regional Medical Center, Colton, USA 6. Neurosurgery, California University of Science and Medicine, Colton, USA
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