title: Aggressive behavior of epilepsy patients in the course of levetiracetam add-on therapy: report of 33 mild to severe cases.
abstract: Levetiracetam (LEV) was shown to be very efficacious and well tolerated as add-on therapy for refractory epilepsy. Here we report 33 patients with longstanding histories of epilepsy who experienced aggressive episodes during LEV therapy. This corresponds to 3.5% of LEV-treated patients as compared with less than 1% of patients not on LEV. Among these cases, 24 showed only moderate, partly transient irritability, with 10 patients requiring reduction or discontinuation of LEV. More strikingly, 9 patients displayed severe symptoms of aggression with physical violence and, in 2 cases, the need for psychiatric emergency treatment. One patient developed additional psychotic symptoms. We suggest that, specifically in patients with a previous history of aggression, behavioral tolerability of LEV should be carefully monitored.
authors.affiliation: Department of Epileptology, University of Bonn Medical Center, Sigmund-Freud Strasse 25, 53105 Bonn, Germany. vera.dinkelacker@ukb.uni-bonn.de
authors.forename: Vera
authors.initials: V
authors.lastname: Dinkelacker
authors.forename: Thomas
authors.initials: T
authors.lastname: Dietl
authors.forename: Guido
authors.initials: G
authors.lastname: Widman
authors.forename: Ulrike
authors.initials: U
authors.lastname: Lengler
authors.forename: Christian E
authors.initials: CE
authors.lastname: Elger
mesh_terms: D000328:Adult; D000368:Aged; D000374:Aggression / Q000187:drug effects*; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D007508:Irritable Mood / Q000502:physiology; D000077287:Levetiracetam; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010889:Piracetam / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam