Safety and efficacy of levetiracetam for patients with panic disorder: results of an open-label, fixed-flexible dose study.
OBJECTIVE
To examine the safety and efficacy of the anticonvulsant levetiracetam in the treatment of patients with panic disorder.


METHODS
In an open-label, fixed-flexible dose study, 18 patients with panic disorder with or without agoraphobia (DSM-IV diagnostic criteria) were treated with levetiracetam for 12 weeks. Outcome was assessed with standard rating instruments (Clinical Global Impressions-Severity of Illness scale [CGI-S], Clinical Global Impressions-Improvement scale [CGI-I], and the 14-item Hamilton Rating Scale for Anxiety [HAM-A]) and by the number of panic attacks during the previous week. The study was conducted in 2 outpatient clinics in New York City from January 2004 through July 2005.


RESULTS
Of the 13 patients completing the study, 11 were rated "very much" or "much" improved on the CGI-I. Panic attack frequency, anxiety (HAM-A), and global severity (CGI-S) ratings also demonstrated significant improvement (all p < .00). For most patients, clinical benefits were apparent after only 1 to 2 weeks of treatment. Levetiracetam was well tolerated with minimal side effects.


CONCLUSIONS
Given its favorable pharmacokinetics, side effect profile, and, if confirmed, early onset of action and efficacy, levetiracetam might represent significant progress in the pharmacologic management of panic disorder.
Papp
Laszlo A
LA
Columbia University, New York State Psychiatric Institute, and Hillside Hospital, New York, NY 10032, USA. lap2@columbia.edu
D000293:Adolescent; D000328:Adult; D000379:Agoraphobia / Q000188:drug therapy / Q000453:epidemiology; D000553:Ambulatory Care; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000188:drug therapy* / Q000453:epidemiology; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam