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Trial compares Levetiracetam vs Carbamazepine monotherapy for pediatric focal epilepsy

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Created On: 10/05/2024

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For the management of pediatric focal epilepsy, both Carbamazepine and Levetiracetam exhibit similar efficacy in seizure control, but Carbamazepine is linked to more adverse events and poorer patient compliance.

In a randomized controlled clinical trial, Carbamazepine (CBZ) and Levetiracetam (LEV) demonstrated equal efficacy in controlling focal seizures in children over 24 weeks, but Carbamazepine led to more adverse events, emphasizing the need to consider tolerability in treatment choices. In this single-center, double-blind, parallel-group study, investigators sought to determine the efficacy and adverse effects of CBZ versus LEV monotherapy in children suffering from focal seizures.

Overall, 120 recently diagnosed focal seizure patients aged 2 to 14 were enrolled and randomly allocated to get either CBZ at a dose of 15 to 20 mg/kg or LEV at a dose of 20 to 40 mg/kg daily. At weeks 4, 12, and 24, the enrolled subjects were monitored for improvement and adverse effects. Six patients were excluded owing to complications related to CBZ. The mean seizure frequency and the number of seizure-free patients in the study groups are depicted in Table 1:

However, the incidence of agitation, dermatologic complications, and somnolence was quite greater in the CBZ group (P < 0.05). Although both medications illustrated comparable effectiveness in seizure control, CBZ was linked with more adverse effects and lower patient compliance. Physicians must take note of these differences to mitigate potential unwanted outcomes.