Combination Therapy with Valproic Acid and Levetiracetam

Efficacy of Combination Therapy

• The American College of Emergency Physicians recommends that both valproic acid and levetiracetam are effective second-line options for treating seizures, with similar efficacy rates (46% for valproate vs 47% for levetiracetam) 1, 2

Safety Profile

• The frequency of potentially life-threatening hypotension is lower with levetiracetam (0.7%) than with valproic acid (1.6%) 2, 3
• Arrhythmias were observed in only 0.7% of the levetiracetam group, while endotracheal intubation occurred in 20% of the levetiracetam group and 16.8% of the valproate group 3
• The most common serious adverse events (observed in 42% of subjects) were continuous seizures, altered level of consciousness, and respiratory difficulty 3