title: Obsessive-compulsive behavior induced by levetiracetam.
abstract: A novel antiepileptic drug, levetiracetam, has been reported to cause several psychiatric adverse effects in spite of its effectiveness on epilepsy. However, a possible relationship between levetiracetam and obsessive-compulsive behavior has only been reported in a few studies with adult epilepsy patients. We treated a pediatric patient with epilepsy without past or family history of psychiatric disorder. Levetiracetam was started to control generalized tonic-clonic seizure. Two months after initiation of levetiracetam with favorable seizure control, she started to show an obsessive-compulsive behavior such as repetitive checking of her back, pants, and chair. Based on the course of its appearance, levetiracetam administration was identified as a possible cause. After termination of levetiracetam, her obsessive-compulsive behavior completely disappeared with reappearance of seizures. This case provides clear evidence that levetiracetam may cause obsessive-compulsive behavior even in a pediatric epilepsy patient without psychiatric background, possibly mediated by modulation of the glutamate system by levetiracetam.
authors.affiliation: Department of Epileptology, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Mayu
authors.initials: M
authors.lastname: Fujikawa
authors.affiliation: Department of Epileptology, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Kishimoto
authors.affiliation: Department of Epileptology, Tohoku University School of Medicine, Sendai, Miyagi, Japan kakisuke@mui.biglobe.ne.jp.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kakisaka
authors.affiliation: Department of Epileptology, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Jin
authors.affiliation: Department of Neurology, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Iwasaki
authors.affiliation: Department of Epileptology, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Nakasato
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D009771:Obsessive-Compulsive Disorder / Q000139:chemically induced*; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam
keywords: glutamate; levetiracetam; obsessive-compulsive behavior