Abstract ID: A3

Abstract Title: Effectiveness of Levetiracetam in the management of neuropathic pain

Poster Type: Either


ABSTRACT BODY

Introduction:The efficacy of anticonvulsants in the symptomatic management of neuropathic pain syndromes has been reported. Levetiracetam is approved as adjuvant therapy of partial onset seizures, and has shown efficacy in refractory migraine headache, and neuropathic pain. This is a prospective, randomized, placebo-controlled trial of Levetiracetam tolerability and effectiveness in the treatment of neuropathic pain

Materials and Methods:Forty-eight consecutive patients with moderate to severe neuropathic pain were randomly assigned to receive Levetiracetam, or placebo. Demographics, baseline characterististics were comparable in both groups.Table 1

Levetiracetam was initiated at 500 mg BID and increased to 1000 mg BID in two weeks, then to 1500 mg in two weeks. Patients were observed for three months. Using the brief pain inventory, pain, mood, general activity, and sleep quality were assessed on an 11-point scale (0=no pain, most active, great mood, best sleep; 10=worst pain, mood, or sleep quality, least active). Evaluations were performed at baseline, 2, 4, 6, 8, and 12 weeks. Laboratory studies (CBC, LFTs, serum electrolytes were done at base line, week 6, and week 12 or study termination



Results:Mean Pain scores, pain interfering with general activity, mood, sleep quality showed improvement with statistical signeficance in the Levetiracetam group Vs. the placebo group. Table 2
Adverse events were mild and included somnolence, fatigue, blurred vision, and short-term memory dysfunction. These events, however, were transient and improved over the initial 3 weeks of treatment. There were no clinically significant changes in laboratory studies


Discussion: Both epilepsy and neuropathic pain share some pathophysilogic mechanisms. Multiple antiepileptics have shown efficacy in the treatment of neuropathic pain enteties .However, tolerance to these medication as well as end point assessment might vary in both groups of patients.
Based on our findings,In patients with moderate to severe neuropathic pain, Levetiracetam should be considered as a safe and effective treatment option. However, larger trials should be sought.


ATTACHED FILES

A3_Table 1.rtf

A3_two.rtf



Reg Anesth Pain Med 2004; 29(2):A3