Objective:

The effects of levetiracetam on hemogram parameters are comparable with other antiepileptics. This study aimed to compare the effects of levetiracetam monotherapy for at least 6 months on hemogram indices with valproic acid.

Methods:

Cases aged 6-18 years who received levetiracetam (n = 42) or valproic acid (n = 46) monotherapy for at least 6 months were randomly selected. The hemogram data closest to the study cutoff point of those who completed a minimum of 6 months of monotherapy were recorded. White blood cell count, neutrophil count, lymphocyte count, red blood cell distribution width, platelet, mean platelet volume, neutr ophil /lymp hocyt e ratio, red cell distribution width to platelet ratio, mean platelet volume to platelet ratio, platelet to lymphocyte ratio, and lymphopenic case rates were compared between levetiracetam and valproic acid groups.

Results:

The number of lymphopenic cases (absolute lymphocyte < 1500/mm3) was higher in the levetiracetam group (n = 8) compared to the valproic acid group (n = 3) (log-rank analysis, P = .002). The lymphocyte count was found to be lower in the levetiracetam group compared to the valproic acid group (mean 2274 ± 964 vs. 2523 ± 653, P = .153). The neutr ophil /lymp hocyt e ratio (mean 2.4 ± 2.3 vs. 1.6 ± 1.3, P = .042) and platelet to lymphocyte ratio indices (mean 141 ± 63 vs. 105 ± 40, P = .002) associated with lymphocyte count were significantly higher in the levetiracetam group.

Conclusion:

Levetiracetam has more lymphopenia side effects than valproic acid. Viral, fungal, and opportunistic infections that develop during levetiracetam treatment may be due to lymphopenia. In cases deemed necessary, absolute lymphocyte count, lymphocyte subgroup analysis, and serum immunoglobulin levels should be reviewed.

Keywords: Levetiracetam, leukocytes, lymphocyte, lymphopenia, platelet