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Translation of a-t 2019; 50: 56


Significant weight loss with levetiracetam (KEPPRA, generics)

An 82 year-old female patient with a normal weight (49 kg) for her height (141 cm) was treated with levetiracetam (KEPPRA, generics) after a seizure. As she did not experience a feeling of hunger, she lost over 9 kg in the subsequent five months while taking the antiepileptic medication. Since the patient does not have a tumour disease and no other possible cause for the significant weight loss was able to be identified, levetiracetam was suspected of being the cause (NETZWERK report 17.652). Already in 2003, four patients were described who lost between 20 kg and 35 kg while taking levetiracetam at 2,000 mg to 3,000 mg per day over a period of five to twelve months. Their weight stabilised or increased when the dose was reduced or they discontinued the antiepileptic drug (1). Nineteen patients at two French epilepsy centres also experienced a weight reduction that was serious in some cases (5 kg to 20 kg) after they started taking levetiracetam. Seven of the patients discontinued levetiracetam and subsequently gained weight or were able to stabilise their weight. Twelve patients continued to take the drug with the weight of eleven of them stabilising at a lower level. Some patients were happy with the weight loss they achieved (2). Weight changes also occur in patients being treated with other antiepileptic drugs. Weight loss, for example, occurs with topiramate* (TOPAMAX, generics) and felbamate (TALOXA), weight gain with valproic acid (ERGENYL, generics), gabapentin (NEURONTIN, generics) or pregabalin (LYRICA, generics) (3). Various Summaries of Product Characteristics (SPCs, 4-6), including that for levetiracetam, are listing both weight loss and weight gain as adverse effects. If patients receiving antiepileptic treatment report noticeable changes in weight, the medication should also be considered as a cause.

1HADJIKOUTIS, S. et al.: BMJ 2003; 327: 905
2GELISSE, P. et al.: Epilepsia 2008; 49: 308-15
3BEN-MENACHEM, E.: Epilepsia 2007; 48 (Suppl. 9): 42-5
4UCB: SPC KEPPRA, as at Apr. 2018
5Janssen: SPC TOPAMAX, as at Oct. 2018
6Pfizer: SPC LYRICA as at Febr. 2019
* Despite considerable adverse drug effects topiramate is authorised in the USA in a fixed combination with phentermine (QSYMIA) to treat obesity (a-t 2015; 46: 18-20).

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