Abstract
For decades, phenytoin has been the drug of choice for the treatment of epilepsy but also the second-line treatment for status epilepticus (SE). However, newer antiepileptic drugs (AEDs) have emerged as safer alternatives for the suppression of seizures. Consequently, phenytoin has recently fallen under scrutiny in the research world, prompting many studies to compare its efficacy to these other drugs, most notably levetiracetam. Levetiracetam is a second-generation AED, which is gaining wide clinical use as the second-line agent in treating SE patients. This review focuses on several clinical studies that have directly compared the effectiveness of phenytoin and levetiracetam in suppressing SE seizure activity. Additionally, this review highlights several advantages of using levetiracetam over phenytoin in this clinical context.
Highlights
BackgroundEpilepsy is a chronic neurological disease that affects approximately 70 million people worldwide[1]
Consistent with previous findings of Wani et al, which was a smaller study, this study showed no significant differences in fosphenytoin, levetiracetam, and valproate efficacies across the age groups [19]
The study findings showed levetiracetam was more effective than phenytoin in suppressing seizures
Summary
Epilepsy is a chronic neurological disease that affects approximately 70 million people worldwide[1]. If seizure activity does not suppress, it is a common clinical practice to prescribe the patient either phenytoin, levetiracetam, or valproate [10,11,12]. Despite this uncertainty, research has confirmed that levetiracetam binds to a synaptic vesicle protein called SV2A, leading researchers to postulate that levetiracetam’s antiepileptic activity might derive from the modulation of this protein and its interactions [52,56]. A systematic review of various clinical studies evaluating phenytoin and levetiracetam effectiveness in treating SE patients reveals that levetiracetam is comparable to phenytoin in suppressing seizure activity in SE patients and has fewer adverse effects.
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