Levetiracetam as an adjunct to phenobarbital treatment in cats with suspected idiopathic epilepsy

J Am Vet Med Assoc. 2008 Mar 15;232(6):867-72. doi: 10.2460/javma.232.6.867.

Abstract

Objective: To assess pharmacokinetics, efficacy, and tolerability of oral levetiracetam administered as an adjunct to phenobarbital treatment in cats with poorly controlled suspected idiopathic epilepsy. DESIGN-Open-label, noncomparative clinical trial.

Animals: 12 cats suspected to have idiopathic epilepsy that was poorly controlled with phenobarbital or that had unacceptable adverse effects when treated with phenobarbital.

Procedures: Cats were treated with levetiracetam (20 mg/kg [9.1 mg/lb], PO, q 8 h). After a minimum of 1 week of treatment, serum levetiracetam concentrations were measured before and 2, 4, and 6 hours after drug administration, and maximum and minimum serum concentrations and elimination half-life were calculated. Seizure frequencies before and after initiation of levetiracetam treatment were compared, and adverse effects were recorded.

Results: Median maximum serum levetiracetam concentration was 25.5 microg/mL, median minimum serum levetiracetam concentration was 8.3 microg/mL, and median elimination half-life was 2.9 hours. Median seizure frequency prior to treatment with levetiracetam (2.1 seizures/mo) was significantly higher than median seizure frequency after initiation of levetiracetam treatment (0.42 seizures/mo), and 7 of 10 cats were classified as having responded to levetiracetam treatment (ie, reduction in seizure frequency of >or=50%). Two cats had transient lethargy and inappetence.

Conclusions and clinical relevance: Results suggested that levetiracetam is well tolerated in cats and may be useful as an adjunct to phenobarbital treatment in cats with idiopathic epilepsy.

MeSH terms

  • Animals
  • Anticonvulsants / therapeutic use*
  • Cat Diseases / drug therapy*
  • Cats
  • Drug Therapy, Combination
  • Epilepsies, Partial / drug therapy
  • Epilepsies, Partial / veterinary
  • Epilepsy / drug therapy
  • Epilepsy / veterinary*
  • Epilepsy, Generalized / drug therapy
  • Epilepsy, Generalized / veterinary
  • Female
  • Half-Life
  • Levetiracetam
  • Male
  • Phenobarbital / adverse effects
  • Phenobarbital / therapeutic use*
  • Piracetam / analogs & derivatives*
  • Piracetam / pharmacokinetics
  • Piracetam / therapeutic use
  • Treatment Outcome

Substances

  • Anticonvulsants
  • Levetiracetam
  • Phenobarbital
  • Piracetam