title: A systematic review of the behavioral effects of levetiracetam in adults with epilepsy, cognitive disorders, or an anxiety disorder during clinical trials.
abstract: This report reviews behavioral adverse events occurring among adults receiving levetiracetam (LEV) or placebo who participated in short-term, placebo-controlled studies in epilepsy (1023), cognitive disorders (719), or anxiety disorders (1510) and epilepsy patients (1393) observed in long-term trials. Behavioral events (affective, psychotic, and suicidal symptoms) were significantly more common among epilepsy patients than cognition or anxiety patients treated with LEV for similar durations (P=0.022). Affective symptoms occurring at 1% or more often in epilepsy placebo-controlled trials included depression (3.8% LEV-2.1% placebo), nervousness (3.8%-1.8%), hostility (2.3%-0.9%), anxiety (1.8%-1.1%), and emotional lability (1.7%-0.2%). Patients with cognitive and anxiety disorders had lower incidences of these symptoms. The incidence of behavioral events in LEV-treated epilepsy patients was lower than rates reported for some other antiepileptic drugs. These data support the hypothesis that some feature related to epilepsy is the cause of many behavioral events rather than the addition of a specific antiepileptic drug.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, 950 Campbell Avenue (G7E, Room 7-127), West Haven, CT 06516-2770, USA. joyce.cramer@yale.edu
authors.forename: Joyce A
authors.initials: JA
authors.lastname: Cramer
authors.forename: Katrien
authors.initials: K
authors.lastname: De Rue
authors.forename: Orrin
authors.initials: O
authors.lastname: Devinsky
authors.forename: Pascal
authors.initials: P
authors.lastname: Edrich
authors.forename: Michael R
authors.initials: MR
authors.lastname: Trimble
mesh_terms: D006801:Humans; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004827:Epilepsy / Q000188:drug therapy; D005500:Follow-Up Studies; D000077287:Levetiracetam; D019964:Mood Disorders / Q000175:diagnosis; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010507:Periodicity; D010889:Piracetam / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D011618:Psychotic Disorders / Q000175:diagnosis; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam