Psychiatric adverse events in patients with epilepsy and learning disabilities taking levetiracetam.
OBJECTIVE
To investigate the prevalence and psychopathological features of psychiatric adverse events (PAEs) in patients with learning disabilities (LD) in therapy with levetiracetam (LEV).


METHODS
From a population of 517 consecutively patients with epilepsy started on LEV, we identified 118 patients with epilepsy and LD.


RESULTS
Fifteen patients (12.7%) experienced PAEs during LEV therapy. Two (1.7%) developed an affective disorder, nine (7.6%) aggressive behaviour, two (1.7%) emotion lability and two (1.7%) other personality changes such as agitation, anger and hostile behaviour. We observed a significant association with a previous history of status epilepticus and a previous psychiatric history. We did not find a statistically significant association with epilepsy diagnosis, age at onset or duration of the epilepsy, EEG or MRI features. The titration schedule of LEV appeared not to be relevant.


CONCLUSIONS
LEV therapy was well tolerated in patients with epilepsy and LD and the main problems were related to aggressive behaviour. The titration schedule of LEV was not relevant and a subgroup of patients appeared to be biologically more vulnerable.
Mula
Marco
M
Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, Queen Square, London, UK. marcomula@yahoo.it
Trimble
Michael R
MR
Sander
Josemir W A S
JW
D000328:Adult; D000704:Analysis of Variance; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D001526:Behavioral Symptoms / Q000139:chemically induced* / Q000145:classification / Q000175:diagnosis; D016009:Chi-Square Distribution; D004827:Epilepsy / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000139:chemically induced*; D000077287:Levetiracetam; D008297:Male; D010889:Piracetam / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015995:Prevalence; D012044:Regression Analysis
D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam