Levetiracetam vs. Valproate as First-Line Treatment for Idiopathic Generalized Epilepsy

A replacement for valproate — a longstanding established drug of choice for the treatment of generalized epilepsies — has been sought for decades. Valproate can have significant adverse effects, including teratogenic risk when used by women of childbearing age and drug-induced weight gain for all patients. For various reasons, including “broad-spectrum” efficacy, absence of drug–drug interactions, and positive safety profile, levetiracetam has become an increasingly popular initial drug chosen for all new-onset seizure disorders, especially idiopathic (primary, genetic) generalized epilepsy (IGE) because of potential adverse effects with valproate, despite a lack of clear trial data supporting any benefit from levetiracetam in most patients…