Levetiracetam (Keppra) Shows Promise in Treating Alcohol Dependence

Anticonvulsants have shown promise as pharmacologic agents in the treatment of alcohol dependence, although none are yet approved by the Food and Drug Administration for this indication. Preliminary evidence suggests that levetiracetam (Keppra), used in treating partial onset seizures, diminished symptoms of alcohol withdrawal. In an open-label study of 20 alcohol dependent persons, investigators assessed the impact of a 10-week course of levetiracetam (1000 mg twice daily) on alcohol consumption.

• Mean daily drinks consumed diminished from >5 per day at baseline to <2 per day during weeks 5–10 (p=.0005). Significant improvements were also observed in alcohol craving scores and the alcohol composite score (but not other composite scores) of the ASI-Lite.*

• Alcohol withdrawal scores were low at baseline (mean CIWA-Ar** score, 2.8) and remained low during the course of the study.

• Side effects were reported in 4 participants and included irritability and sedation.

Comments:

In this study, participants’ alcohol consumption diminished significantly while taking levetiracetam, but, since individual level data were not presented, the proportion of patients achieving abstinence is not known. Because open-label studies cannot distinguish the impact of the medication from that of participants’ motivation to drink less, the study is not definitive. However, because anticonvulsants can reduce withdrawal symptoms and have clear potential for treating alcohol dependence, as recently demonstrated with topiramate, the authors rightly suggest that levetiracetam should next be studied for this indication in a blinded controlled trial. Marc N. Gourevitch, MD, MPH

Reference:

Sarid-Segal O, Piechniczek-Buczek J, Knapp C, et al. The effects of levetiracetam on alcohol consumption in alcohol-dependent subjects: an open label study. Am J Drug Alcohol Abuse. 2008;34(4):441–447.