Levetiracetam for the Treatment of Essential Tremor

<div class="line" id="line-5"> We read with interest the recent article by Handforth and Martin, <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/mds.20437#bib1"> 1 </a> &ldquo;Pilot Efficacy and Tolerability: A Randomized, Placebo&hyphen;Controlled Trial of Levetiracetam for Essential Tremor.&rdquo; We also performed a pilot study of levetiracetam (LEV, Keppra) for essential tremor (ET) in 6 ET patients to assess its safety, tolerability, and preliminary efficacy using an open&hyphen;label design and found similar results. The primary outcome measure for our study was the change in the Fahn&ndash;Tolosa&ndash;Marin (FTM) rating scale from baseline to endpoint. Secondary outcome measures included the Clinical Global Impression (CGI) scale and Epworth Sleepiness Scale (ESS), the latter performed due to the association of somnolence and LEV. <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/mds.20437#bib1"> 1 </a> , <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/mds.20437#bib2"> 2 </a> A baseline score of 15 on the FTM rating scale was required for study inclusion. LEV was titrated by 250 mg/day every 4 days up to a maximum of 3,000 mg per day. Adjunct medications for tremor were permitted but were maintained at a stable dose for 4 weeks before the screening visit and throughout the study. Patients were evaluated at baseline, and on days 12, 24, 36, and 48. Doses of LEV could be stabilized or reduced at study visits according treatment efficacy and side effects. Last observation carried forward (LOCF) was used for patients who dropped out of the study.</div>