Brain with glowing pathways, symbolizing effective epilepsy treatment monitoring.

Levetiracetam Levels: A Simple Way to Monitor Epilepsy Meds?

Samir D’Costa in Health & Wellness December 2025 • 3 min read.

"New research simplifies tracking levetiracetam in plasma and saliva, potentially improving epilepsy management and adherence."

Epilepsy, a neurological disorder affecting millions worldwide, often requires long-term management with antiepileptic drugs (AEDs). Among these, levetiracetam (LEV) stands out due to its effectiveness and relatively favorable side effect profile. Unlike some older AEDs, levetiracetam doesn't heavily rely on liver enzymes for processing, reducing the risk of interactions with other medications.

Keeping the right amount of levetiracetam in the body is essential for controlling seizures. Too little might lead to breakthrough seizures, while too much can cause unwanted side effects. Traditionally, blood tests have been the standard method for monitoring drug levels. However, researchers are increasingly exploring saliva as an alternative, offering a non-invasive and convenient way to track medication levels.

Recent research from the Institute of Psychiatry and Neurology in Warsaw, Poland, has introduced a simplified method for measuring levetiracetam in both plasma and saliva. This new approach utilizes high-performance liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS), offering a sensitive and rapid way to monitor levetiracetam levels. What makes this method particularly appealing is its simplicity and potential for high-throughput analysis.

Why is Monitoring Levetiracetam Important?

Brain with glowing pathways, symbolizing effective epilepsy treatment monitoring.

Effective epilepsy management relies on maintaining levetiracetam levels within a specific therapeutic range. This range represents the sweet spot where the drug effectively controls seizures without causing significant side effects. Several factors can influence levetiracetam levels in the body, including:

Individual metabolism: People process medications differently, affecting how quickly levetiracetam is broken down and eliminated.

Dosage adjustments: Changes in dosage require careful monitoring to ensure levels remain within the therapeutic range.
Co-administered medications: Although levetiracetam has fewer interactions than some AEDs, other drugs can still affect its levels.
Adherence: Consistent medication taking is crucial. Monitoring can help identify potential adherence issues.

Traditional methods for monitoring levetiracetam involve blood draws, which can be inconvenient, especially for children or individuals requiring frequent monitoring. The ability to use saliva samples offers a less invasive and potentially more convenient alternative, especially when frequent measurements are needed.

The Future of Levetiracetam Monitoring

The development of simple, sensitive methods for monitoring levetiracetam levels represents a significant step forward in epilepsy management. The new LC-MS/MS method offers a rapid and reliable way to measure levetiracetam in both plasma and saliva, potentially improving patient care and treatment outcomes. While further research is needed to fully validate the use of saliva monitoring in clinical practice, this approach holds great promise for making epilepsy management more convenient and patient-centered.

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Everything You Need To Know

What is levetiracetam and why is it used?

Levetiracetam, known as LEV, is a medication used to manage epilepsy. It's favored because it's effective and has fewer side effects compared to older antiepileptic drugs. It is significant because it does not rely heavily on liver enzymes, which reduces the risk of interactions with other medications. This is important because managing drug interactions simplifies the treatment for individuals taking multiple medications.

Why is it important to monitor levetiracetam levels in the body?

Monitoring levetiracetam levels is crucial to ensure that the concentration of the drug in the body is within the therapeutic range. This range is where levetiracetam effectively controls seizures without causing significant side effects. Without proper monitoring, levels may fall outside of this therapeutic window. Too little levetiracetam might result in breakthrough seizures, while too much can cause adverse side effects, which can affect patient health and quality of life.

What factors can affect the levels of levetiracetam in the body?

Several factors can influence levetiracetam levels in the body. These include individual metabolism, dosage adjustments, co-administered medications, and adherence to the prescribed regimen. Individual metabolism varies from person to person, affecting how quickly levetiracetam is processed and eliminated. Dosage adjustments require careful monitoring to maintain levels within the therapeutic range. Other drugs can affect levetiracetam levels, though levetiracetam has fewer interactions than some AEDs. Consistent medication adherence is critical, and monitoring can identify potential issues, each playing a critical role in maintaining stable drug levels.

What is the LC-MS/MS method and why is it useful?

The LC-MS/MS method is a simplified approach for measuring levetiracetam in plasma and saliva. It stands for high-performance liquid chromatography coupled with tandem mass spectrometry. It offers a sensitive and rapid way to monitor levetiracetam levels. This method is appealing because of its simplicity and potential for high-throughput analysis, allowing for quicker and more efficient monitoring of medication levels.

What are the benefits of using saliva to monitor levetiracetam levels?

Saliva monitoring offers a non-invasive and convenient alternative to traditional blood tests for tracking levetiracetam levels. This is especially beneficial for individuals requiring frequent monitoring, such as children, for whom blood draws can be particularly challenging. Saliva monitoring can improve patient compliance and ease of use, potentially leading to better management of epilepsy.