From the FDA Drug Label
The effectiveness of levetiracetam as adjunctive therapy (added to other antiepileptic drugs) in patients 12 years of age and older with juvenile myoclonic epilepsy (JME) experiencing myoclonic seizures was established in one multicenter, randomized, double-blind, placebo-controlled study, conducted at 37 sites in 14 countries Table 5 displays the results for the 113 patients with JME in this study Table 5: Responder Rate (≥50% Reduction From Baseline) In Myoclonic Seizure Days Per Week for Patients with JME Placebo(N=59)Levetiracetam(N=54)
- statistically significant versus placebo Percentage of responders23.7%60. 4%*
The best treatment for juvenile myoclonic epilepsy in a 14-year-old girl is levetiracetam.
- The recommended dose is 1000 mg/day, given as twice-daily dosing (500 mg BID), with dosage increased by 1000 mg/day every 2 weeks to the recommended daily dose of 3000 mg.
- Levetiracetam has been shown to be effective in reducing the frequency of myoclonic seizures in patients with JME, with a responder rate of 60.4% compared to 23.7% for placebo 1.
From the Research
The best treatment for juvenile myoclonic epilepsy (JME) in a 14-year-old girl is levetiracetam (Keppra) at 500-1000 mg twice daily, due to its efficacy and safety profile, especially considering the potential teratogenic effects of valproate in females of reproductive age. When considering treatment options for JME, it is essential to weigh the benefits and risks of each medication.
- Sodium valproate (Depakote) has a high response rate of up to 80% 2, but its use is limited in females of childbearing age due to the risk of fetal malformations and neurodevelopmental delay.
- Levetiracetam (Keppra) is a suitable alternative, with a low side effect profile and excellent tolerability, making it a preferred first-line option in this patient population 2.
- Lamotrigine (100-200 mg twice daily) or topiramate (50-100 mg twice daily) are also reasonable alternatives, but may have varying degrees of efficacy and tolerability 2, 3. Key considerations in managing JME include:
- Avoiding seizure triggers such as sleep deprivation, alcohol consumption, and excessive stress
- Regular follow-up every 3-6 months to monitor medication effectiveness, side effects, and compliance
- Lifelong therapy is often necessary, as JME typically requires ongoing management It is crucial to individualize treatment based on the patient's specific needs and circumstances, taking into account factors such as comorbidities, lifestyle, and personal preferences 4, 5.