Utility of levetiracetam in patients with subarachnoid hemorrhage.
OBJECTIVE
To determine the utility and tolerability of levetiracetam (LEV) compared to phenytoin (PHT) in preventing clinical seizures in patients with subarachnoid hemorrhage (SAH).


METHODS
Utility and tolerability of PHT and LEV in patients with SAH were determined by the occurrence of breakthrough clinical seizures or adverse events necessitating a change of medication. Comparisons were performed with Chi-square tests.


RESULTS
All 176 patients were initially treated with PHT. No breakthrough clinical seizures occurred. In 70 (39.8%) patients, PHT was replaced with LEV due to adverse events including elevation of transaminases, thrombocytopenia, unexplained fever, rash, gastrointestinal disturbance, and worsening mental status. After switching to LEV, all adverse effects resolved except gastrointestinal disturbance and worsening mental status in 4 patients. Adverse events occurred more often in patients taking PHT.


CONCLUSIONS
In patients with SAH, LEV appears to have superior tolerability compared to PHT.
Department of Medicine (Neurology), Duke University Medical Center, Durham, NC, USA.
Dharmen
D
Shah
Aatif M
AM
Husain
D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D004827:Epilepsy / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D010672:Phenytoin / Q000627:therapeutic use; D010889:Piracetam / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000188:drug therapy*; D016896:Treatment Outcome
D000927:Anticonvulsants; D000077287:Levetiracetam; D010672:Phenytoin; D010889:Piracetam