Epilepsy outcomes with immediate- and extended-release levetiracetam in idiopathic generalized seizures

Idiopathic generalized epilepsy is a neurological disorder characterized by recurrent seizure attacks associated with sudden loss of consciousness. Seizures may present as generalized tonic-clonic or myoclonic episodes and require long-term antiseizure pharmacotherapy. Levetiracetam is a second-generation antiseizure medication available in immediate-release (IR) and extended-release (XR) formulations. The XR formulation enables once-daily dosing, providing more stable plasma concentrations and potentially reducing concentration-related adverse effects. Levetiracetam is rapidly absorbed after oral administration, primarily excreted unchanged in the urine, and has a favorable pharmacokinetic profile with minimal drug–drug interactions. Commonly reported adverse effects include somnolence, irritability, dizziness, nausea, influenza, and nasopharyngitis. Materials and methods. This observational study included 100 patients with idiopathic generalized epilepsy presenting with generalized tonic-clonic and/or myoclonic seizures. Participants were aged 14–20 years (68 males, 32 females) and were divided into two equal groups. One group received IR levetiracetam, while the other received XR levetiracetam. Patients were followed for six months. Clinical seizure response, treatment adherence, adverse effects, and serum levetiracetam concentrations were evaluated during scheduled follow-up visits. Results. Seizure frequency outcomes at six months were similar between the IR and XR levetiracetam groups, with no statistically significant difference in seizure control. However, patients treated with XR levetiracetam demonstrated better treatment compliance and fewer reported adverse effects compared with those receiving IR levetiracetam. Conclusion. XR levetiracetam provided seizure control comparable to IR levetiracetam in adolescents and young adults with idiopathic generalized epilepsy, while offering advantages in tolerability and adherence. Once-daily dosing may contribute to improved compliance and patient satisfaction, supporting XR levetiracetam as a practical option for long-term epilepsy management.