title: Levetiracetam induced acute reversible psychosis in a patient with uncontrolled seizures.
abstract: Levetiracetam (LEV) is a relatively newer antiepileptic drug with novel mechanism of action. It was introduced to the market in the year 2000. Pre-marketing clinical trials of the drug reported good tolerability with a wide safety margin. On post-marketing updates, there are few reports of psychosis after treatment with the drug. Here, we report a case of 52-year-old epileptic man who developed acute, reversible psychosis within 3 days of initiation of treatment. The drug was prescribed at a dose of 500 mg per day. After 3 days of treatment, the patient developed visual hallucinations, mood swings, withdrawal and suspicious behavior. Delirium was ruled out as there was no fluctuation in his sensorium or focal neurological deficits. His lab investigations for electrolytes, renal function test, thyroid, liver function and other related tests levels were within normal limits. A diagnosis of LEV induced psychosis was reached based on clinical judgment and causality assessment.
authors.affiliation: Department of Neurology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India.
authors.forename: Nithin
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Department of Pharmacology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India.
authors.forename: H S
authors.initials: HS
authors.lastname: Swaroop
authors.affiliation: Department of Pharmacology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India.
authors.forename: Ananya
authors.initials: A
authors.lastname: Chakraborty
authors.affiliation: Department of Neurology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India.
authors.forename: Suhas
authors.initials: S
authors.lastname: Chandran
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D004827:Epilepsy / Q000188:drug therapy*; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011605:Psychoses, Substance-Induced / Q000209:etiology* / Q000503:physiopathology
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam
keywords: Adverse drug reaction; anti-seizure drug; antiepileptic drugs; levetiracetam; psychosis