Results from a new study showed that the antiepileptic drug Keppra (levetiracetam), in combination with tricyclic antidepressants, anticonvulsant drugs and/or long-acting narcotics, provided some multiple sclerosis (MS) patients improvement in pain and uncomfortable sensations associated with their condition. The study of Keppra, which is approved by the U.S. Food and Drug Administration for the adjunctive treatment of partial onset seizures in adults with epilepsy, was conducted at the MS Treatment and Research Center of the Yale School of Medicin.

MS affects more than 400,000 people in North America and about 2.5 million worldwide
(1). Over 60 percent of MS patients experience moderate to severe pain, although less than 10 percent are on medication
(2). Frequent syndromes encountered include painful limb spasms; deep, aching leg pain; a burning sensation and uncomfortable buzzing sensations derived from spinal cord involvement.

"We were interested in studying Keppra in combination with more commonly used treatments for neuropathic pain and paresthesias in MS patients. Because of its unique mechanism of action, it can potentially complement other anticonvulsant treatments," said Marco Rizzo, author of the study and assistant professor at the Yale School of Medicine, New Haven, Conn. "We were impressed to find that Keppra was well-tolerated and effective for neuropathic pain and uncomfortable numbness."

In this open-label study, Keppra was given to 21 MS patients who continued to have disabling neuropathic symptoms despite more conventional treatments. More than half of the patients showed marked improvement and continue to be treated with Keppra. In combination with tricyclic compounds, other anticonvulsants, and/or long-acting narcotics, the dose was titrated up to between 500 and 4,500 mg/day.

More than half (12 of 21) of patients exhibited moderate to marked improvement of symptoms as a result of the introduction of Keppra therapy. Three of the 21 patients showed mild improvement; five showed no positive response and one patient discontinued at 500 mg/day due to fatigue and disorientation. Two of the 12 patients who showed moderate or marked symptom improvement were able to discontinue all other pain therapies after treatment for 4 to 8 months. A majority of the patients remain on adjunctive Keppra treatment.