Cochrane Database Syst Rev. 2014 Jul 7;7:CD010943. doi: 10.1002/14651858.CD010943.pub2.

Levetiracetam for neuropathic pain in adults

Wiffen PJ, Derry S, Moore RA, Lunn MP.

This Cochrane systematic review aimed to evaluate the analgesic efficacy and adverse events of levetiracetam in chronic neuropathic pain using randomised, double-blind studies of greater than two weeks duration. Six studies were included, five were small with a cross-over design (aggregated n=170), and one was a larger parallel group study (n=170). These had a duration of between four and 14 weeks. Patients had neuropathic pain from numerous aetiologies including central pain due to multiple sclerosis, stroke and spinal cord injury, polyneuropathy, postherpetic neuralgia, and post-mastectomy pain. The evidence was very low quality due to small study sizes and the way in which the participant withdrawal data was used. Individual studies and pooled results for `substantial` pain relief (from four of the studies) showed a similar analgesic response from both levetiracetam (doses were between 2000 to 3000 mg daily) and placebo. Based on very limited data, more participants experienced adverse events and adverse event withdrawals with levetiracetam. Based on the currently available studies levetiracetam was not recommended for neuropathic pain management in adults.

Prepared by Jason Boland