black cat lying on wooden floor

Should Levetiracetam or Imepitoin Be Used in Preference as Second-line Treatment in Pharmacoresistent Epileptic Cats?

Sophie Elizabeth Wyatt

Published:  28/06/2019    in:  Knowledge Summaries
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black cat lying on wooden floor
PICO question

In adult cats with idiopathic epilepsy, which is poorly controlled with phenobarbital monotherapy, should levetiracetam or imepitoin be used in preference as a second line treatment in order to reduce seizure frequency?

Clinical bottom line

There is currently insufficient evidence to reliably determine whether levetiracetam or imepitoin should be used in preference as a second line treatment for the management of cats with refractory idiopathic epilepsy. There is weak evidence however to suggest clinical efficacy of levetiracetam and imepitoin in management of cats with idiopathic epilepsy. Further studies which evaluate and directly compare the efficacy of second line anticonvulsants in feline epilepsy are needed.

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  1. Charalambous, M., Pakozdy, A., Bhatti, S.F.M., and Volk, H.A. Systematic review of antiepileptic drugs’ safety and effectiveness in feline epilepsy. BMC Vet Res. 2018; 14(1). DOI:
  2. Bailey, K.S., Dewey, C.W., Boothe, D.M., Barone, G., and Kortz, G.D. Levetiracetam as an adjunct to phenobarbital treatment in cats with suspected idiopathic epilepsy. J Am Vet Med Assoc. 2008; 232(6): 867–872. DOI:
  3. Engel, O., van Klopmann, T., Maiolini, A., Freundt-Revilla, J., and Tipold, A. Imepitoin is well tolerated in healthy and epileptic cats. BMC Vet Res. 2017; 13(1). DOI:

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