The role of levetiracetam in the modulation of pain through serotonin receptors

Levetiracetam (LEV) is a second generations antiepileptic drug that belongs to the pyrrolidine family. It exhibits an excellent pharmacological profile and has been employed in a myriad of complex clinical instances. LEV has been proven to be effective in the preclusion of different types of epilepsy, it has been employed as monotherapy and as adjuvant for the prevention of posttraumatic convulsions and more recently LEVs efficacy and safety has been reported in neonatal convulsions. Likewise, it has been proposed that LEV possesses neuroprotective properties in epileptic and non-epileptic disorders. Due to the great importance that has been given recently to antiepileptic drug repositioning for the treatment of pain, and the novel molecular targets that could be altering the nociceptive response, new lines of research employing LEV as an analgesic drug have emerged with controversial results. Nevertheless, some researchers have proposed that the antinociceptive effect of LEV is dependent of the serotoninergic system. Serotonin is a monoamine that is widely distributed in the human body, both in the central (CNS) and peripheral nervous system (PNS), it is involved in physiologic and behavioral disorders like depression, anxiety, schizophrenia, autism, obesity, pain among many others. Many studies have positioned the serotoninergic receptors as modulators of the central nociceptive response, however, their action seems to be variable and is still a matter of debate among the scientific community. For this reason, the objective of the current chapter is to present an analysis of the administration of LEV over the expression of serotoninergic receptors involved in nociception.