In patients with Parkinson's disease, the antiepileptic drug levetiracetam (Keppra(R)) reduced the involuntary movements (dyskinesia) associated with levodopa, the medication most commonly used to treat Parkinson's disease, according to a study presented today at the 56th annual meeting of the American Academy of Neurology.
The independent study is one of the first to specifically evaluate an antiepileptic drug for the treatment of levodopa-induced dyskinesia in Parkinson's patients. "Levodopa-induced dyskinesia remains one of the biggest challenges in treating Parkinson's disease because it is a common side effect and is difficult to manage," said lead investigator Theresa Zesiewicz, M.D., assistant director of the Parkinson's Disease and Movement Disorders Center, and associate professor of neurology at the University of South Florida.
She explained that levodopa can effectively control Parkinson's disease symptoms -- stiffness, slow movement and tremors -- but after five to eight years, it often causes the side effect of dyskinesia. "Our study showed levetiracetam reduced dyskinesia and, importantly, did not interfere with the efficacy of levodopa in controlling Parkinson's disease symptoms," she said. An anticonvulsant with a novel mechanism of action, levetiracetam is currently approved by the U.S. Food and Drug Administration for the adjunctive treatment of partial-onset seizures in adults.
The prospective, open-label pilot study included nine Parkinson's disease patients (three women and six men, average age 65 years) being treated with levodopa and who were experiencing peak-dose dyskinesia for at least 25 percent of their waking hours.
Two patients dropped out before completing their diaries, leaving seven patients for the efficacy analysis. Ten days of treatment with levetiracetam resulted in changes suggesting improvement in levodopa-induced dyskinesia. Further analysis after 60 days of treatment with levetiracetam yielded the following results: