title: Pyridoxine supplementation for the treatment of levetiracetam-induced behavior side effects in children: preliminary results.
abstract: Behavioral side effects related to the use of levetiracetam (LEV) in epilepsy are increasingly being recognized. Patients followed in our center have reported improvement of these side effects after starting pyridoxine (vitamin B(6)) supplements. Using mailed questionnaires, retrospective chart reviews, and phone call follow-ups, we analyzed 42 pediatric patients who had been treated with LEV and pyridoxine. Twenty-two patients started pyridoxine after being on LEV, and significant behavioral improvement was observed in nine (41%), no effect in eight (36%), deterioration in four (18%), and an uncertain effect in one. The effects of pyridoxine supplementation were observed during the first week. The remaining patients (20) were already on pyridoxine before LEV was started, started pyridoxine and LEV at the same time, or took pyridoxine intermittently. Pyridoxine is an easily available, inexpensive, and safe therapeutic option. Given these preliminary results, we plan to conduct a placebo-controlled cross-over study to better characterize these observations.
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA.
authors.forename: Philippe
authors.initials: P
authors.lastname: Major
authors.forename: Erica
authors.initials: E
authors.lastname: Greenberg
authors.forename: Alisa
authors.initials: A
authors.lastname: Khan
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Thiele
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects*; D001526:Behavioral Symptoms / Q000139:chemically induced* / Q000178:diet therapy*; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives*; D011736:Pyridoxine / Q000008:administration & dosage*; D012189:Retrospective Studies; D014803:Vitamin B Complex / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D014803:Vitamin B Complex; D000077287:Levetiracetam; D011736:Pyridoxine; D010889:Piracetam