From the Research
Levetiracetam is considered a safe and effective treatment for neonatal seizures, with a favorable side effect profile and minimal impact on the developing brain, and can be used as a first-line treatment with a loading dose of 20-50 mg/kg and maintenance dose of 10-60 mg/kg/day divided into two doses. The most recent and highest quality study, 1, published in 2022, compared the efficacy and safety of levetiracetam and phenobarbital as first-line treatments for neonatal seizures and found that levetiracetam was more effective in achieving seizure control and had a lower risk of adverse effects.
Some key points to consider when using levetiracetam in neonates include:
- Minimal drug interactions and limited protein binding, making it a good option for patients with multiple medical conditions or taking other medications 2, 3
- Primarily renal elimination without hepatic metabolism, reducing the risk of drug interactions and adverse effects 4, 5
- Favorable side effect profile compared to phenobarbital and phenytoin, with common side effects including somnolence and irritability 3, 1
- Dose adjustments may be necessary for premature infants or those with renal impairment, with typical dosing ranging from 10-60 mg/kg/day divided into two doses 2, 5
Overall, levetiracetam is a valuable treatment option for neonatal seizures, offering a favorable safety profile and effective seizure control, and can be used as a first-line treatment in this population.