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左乙拉西坦用于治疗神经和精神疾病。

Levetiracetam for managing neurologic and psychiatric disorders.

作者信息

Farooq Muhammad U, Bhatt Archit, Majid Arshad, Gupta Rishi, Khasnis Atul, Kassab Mounzer Y

机构信息

Department of Neurology and Ophthalmology, Michigan State University, 138 Service Road, East Lansing, MI 48824, USA.

出版信息

Am J Health Syst Pharm. 2009 Mar 15;66(6):541-61. doi: 10.2146/ajhp070607.

Abstract

PURPOSE

The role of levetiracetam in different epileptic, nonepileptic, neurologic, and psychiatric disorders is discussed.

SUMMARY

Levetiracetam, an antiepileptic drug (AED), was first approved as an adjunctive therapy for the treatment of partial epilepsy in adults. It is currently being used in the treatment of multiple seizure disorders, including generalized tonic-clonic; absence; myoclonic, especially juvenile myoclonic; Lennox-Gastaut syndrome; and refractory epilepsy in children and adults. Data are emerging on possible uses of levetiracetam outside the realm of epilepsy because of its unique mechanisms of action. There is preliminary evidence about the efficacy of levetiracetam in the treatment of different psychiatric disorders, including anxiety, panic, stress, mood and bipolar, autism, and Tourette's syndrome. The most serious adverse effects associated with levetiracetam use are behavioral in nature and might be more common in patients with a history of psychiatric and neurobehavioral problems.

CONCLUSION

Levetiracetam is an effective AED with potential benefits in other neurologic and psychiatric disorders. The benefit-risk ratio in an individual patient with a specific condition should be used to determine its optimal use. Levetiracetam's use in nonepileptic conditions is not recommended until more data become available from larger trials.

摘要

目的

探讨左乙拉西坦在不同癫痫、非癫痫、神经和精神疾病中的作用。

总结

左乙拉西坦是一种抗癫痫药物(AED),最初被批准作为辅助治疗用于成人部分性癫痫的治疗。目前它正被用于治疗多种癫痫发作疾病,包括全身强直阵挛发作;失神发作;肌阵挛发作,尤其是青少年肌阵挛发作;Lennox-Gastaut综合征;以及儿童和成人的难治性癫痫。由于其独特的作用机制,有关左乙拉西坦在癫痫领域之外可能用途的数据正在不断涌现。有初步证据表明左乙拉西坦在治疗不同精神疾病方面具有疗效,包括焦虑、惊恐、应激、情绪和双相情感障碍、自闭症以及图雷特综合征。与使用左乙拉西坦相关的最严重不良反应本质上是行为方面的,并且在有精神和神经行为问题病史的患者中可能更常见。

结论

左乙拉西坦是一种有效的抗癫痫药物,在其他神经和精神疾病中可能具有益处。对于患有特定疾病的个体患者,应使用其获益风险比来确定其最佳用途。在有更多来自大型试验的数据可用之前,不建议在非癫痫病症中使用左乙拉西坦。

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