Study objective: To report our experience with rapid titration of levetiracetam regimens in children and adolescents who were unresponsive to or intolerant of other antiepileptic drugs.
Methods: A retrospective chart review was performed to identify patients with childhood epilepsy who underwent a rapid titration to full doses of levetiracetam in 2 weeks or less. Data regarding demographics, disease characteristics, previous use of antiepileptics, levetiracetam dosage titration schedule, and clinical outcomes were collected and analyzed.
Results: Eight children (seven girls, one boy) aged 19 months-17 years were identified. The levetiracetam dosage was titrated to full maintenance doses over 2-14 days (mean 10 days). All patients demonstrated greater than 50% reduction in seizure frequency, with six patients (75%) becoming seizure free. Only one patient experienced a clinically significant adverse event.
Conclusion: Rapid dosage titration of levetiracetam is feasible and well tolerated in children who require rapid escalation to therapeutic doses.