Seizure? Who gives benzos, anyway?
It is true that neurologists tend to forgo the first step in the algorithm of seizure/status treatment and start with Levetiracetam instead of benzos. This is, because we don’t like to intubate people.
So why is Levetiracetam so exceptional? True, the side effects are less than in many other antiepileptic (although I am impressed with it’s psychotropic adverse effects). But it is really the pharmakokinetics that allow us to use it so freely and generously. Also, a discussion of Levetiracetam’s pharmakokinetics serves to illustrate the basic principles of pharmacology.
As regards interactions, there are really only pharmacodynamic ones and these are with Carbamazepine and Topiramate where side effects are pronounced in comedication with LEV.
- This is really folklore. Look in Engel’s textbook on Epilepsy.
- Here is a review on LEV’s pharmacokinetics.