Serum concentration/dose ratio of levetiracetam before, during and after pregnancy

Purpose: To investigate changes in levetiracetam (LEV) serum concentration/dose ratio (C/D-ratio) in relation to pregnancy. Methods: Altogether 21 consecutive pregnancies in 20 women with epilepsy receiving LEV during gestation were studied retrospectively. The main target variable was the C/D-ratio before and during pregnancy, and in the post partum period. Secondary target variables were changes in LEV dose, concomitant use of other antiepileptic drugs and seizure frequency. Student's paired t-test and two-sample t-test for independent samples were used to test for statistically significant changes in C/D-ratio means. Results: Mean C/D-ratio in the third trimester was 50% of the mean C/D-ratio at baseline (p < 0.001, n = 11). Baseline Levels were reached within the first weeks after pregnancy. The interindividual variability was pronounced. Conclusions: Serum concentrations of LEV declined significantly in the third trimester of pregnancy and increased rapidly after delivery. (C) 2007 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.