Expert Opinion on the Prescription Practice of Levetiracetam for Different Types of Epilepsy in Indian Clinical Settings

Abstract

Despite some studies assessing antiepileptic drug usage patterns in single-centre settings, there was a lack of consensus regarding usage patterns, drug choices for various seizure types, and the sociodemographic and clinical factors that influence treatment decisions in India. So, this current survey-based study was intended to gather expert opinions regarding the clinical use of anti-epileptic drugs with a special focus on levetiracetam for the management of epilepsy in Indian settings. A questionnaire-based cross-sectional study involving 25 questions collected perspectives of experts across India regarding the prescription practice of anti-epileptic drugs for epilepsy management. It was noted that majority of the responders (85.93% of 192 experts) stated levetiracetam as a preferred therapeutic option for patients with newly diagnosed epilepsy. Levetiracetam 1000 mg/day was the frequently recommended dosage for such patients in clinical practice (66%). Approximately 76% of the experts suggested that patients receiving the drug might experience behavioural changes. About 49% and 82% of responders recommended levetiracetam for treating resistant epilepsy and pregnant epilepsy respectively. Nearly 62% of the clinicians recommended levetiracetam for paediatric patients with partial seizures over other antiepileptic drugs. Levetiracetam and brivaracetam were both rated as beneficial for treating epileptic patients by 50% of clinicians. Levetiracetam was rated as being more effective than brivaracetam by 28% of clinicians, while brivaracetam was rated as being more effective by 14% of clinicians. Hence, this consensus among clinician’s highlights levetiracetam as the preferred antiepileptic medication for the management of patients with recently diagnosed epilepsy. This recommendation extends patients with refractory epilepsy, pregnant subjects with epilepsy, and young children experiencing partial seizures, where the majority of the clinicians endorse levetiracetam over alternative antiepileptic medications. Both levetiracetam and brivaracetam offer comparable treatment benefits for patients with epilepsy.