This has led to the suggestion that levetiracetam exclusively modulates the function of SV2A only under pathophysiological conditions. 7 Stimulation of pre-synaptic SV2A by levetiracetam may inhibit neurotransmitter release, 6 but this action does not appear to affect normal neurotransmission. SV2A is a membrane-bound protein that is found on synaptic vesicles and is ubiquitous throughout the CNS 4 - it appears to play a role in vesicle exocytosis 11, 15 and in the modulation of synaptic transmission by increasing the available amount of secretory vesicles available for neurotransmission. Current knowledge suggests that levetiracetam’s binding to synaptic vesicle protein 2A (SV2A) is a key driver of its action. The exact mechanism through which levetiracetam exerts its anti-epileptic effects is unclear, but is thought to be unique amongst other anti-epileptic medications. 11, 15 The therapeutic index of levetiracetam is wide, 15, 9 making it relatively unique amongst other anti-epileptic medications.Īnti-epileptic drugs, including levetiracetam, may increase the risk of suicidal ideation or behaviour - patients taking levetiracetam should be monitored for the emergence or worsening of depressive symptoms, suicidal ideation, and behavioural abnormalities.

Levetiracetam appears to prevent seizure activity via the selective inhibition of hypersynchronized epileptiform burst firing without affecting normal neuronal transmission, though the exact mechanism through which this occurs is unclear.

Antidote for alprazolam