title: Apparent dose-dependent levetiracetam-induced de novo major depression with suicidal behavior.
abstract: Levetiracetam (LEV) is a novel antiepileptic drug (AED) approved for the adjunctive treatment of generalized and partial seizures. LEV has no clinically significant drug interactions and has limited adverse effects. The psychiatric adverse effects of LEV include de novo psychosis, affective disorder, and aggression. LEV-induced suicidal behavior has been reported infrequently with a past history of affective disorders. The authors report an apparent dose/concentration-dependent LEV-induced de novo major depression with near fatal suicide attempt in a patient without prior history of affective disorder. Psychiatric evaluation with emphasis on historic/current affective disorders, impulsive-aggressive behaviors, and assessment of risk factors for suicidal behaviors is indicated in treating patients with epilepsy with LEV. Clinicians should consider therapeutic drug monitoring to optimize therapeutic LEV treatment.
authors: Department of Psychiatry, Rutgers - Robert Wood Johnson Medical School, 125 Paterson Street, Suite #2200, New Brunswick, NJ 08901, USA ; Department of Neurology, Rutgers - Robert Wood Johnson Medical School, 125 Paterson Street, Suite #2200, New Brunswick, NJ 08901, USA ; Department of Anesthesiology, Rutgers - Robert Wood Johnson Medical School, 125 Paterson Street, Suite #2200, New Brunswick, NJ 08901, USA.
authors: Kenneth R
authors: KR
authors: Kaufman
authors: Department of Psychiatry, Rutgers - Robert Wood Johnson Medical School, 125 Paterson Street, Suite #2200, New Brunswick, NJ 08901, USA.
authors: Viwek
authors: V
authors: Bisen
authors: Department of Psychiatry, Rutgers - Robert Wood Johnson Medical School, 125 Paterson Street, Suite #2200, New Brunswick, NJ 08901, USA ; Department of Neurology, Rutgers - Robert Wood Johnson Medical School, 125 Paterson Street, Suite #2200, New Brunswick, NJ 08901, USA.
authors: Aphrodite
authors: A
authors: Zimmerman
authors: Department of Psychiatry, Rutgers - Robert Wood Johnson Medical School, 125 Paterson Street, Suite #2200, New Brunswick, NJ 08901, USA ; Department of Internal Medicine, Rutgers - Robert Wood Johnson Medical School, 125 Paterson Street, Suite #2200, New Brunswick, NJ 08901, USA.
authors: Anthony
authors: A
authors: Tobia
authors: Department of Neurology, Rutgers - Robert Wood Johnson Medical School, 125 Paterson Street, Suite #2200, New Brunswick, NJ 08901, USA.
authors: Ram
authors: R
authors: Mani
authors: Department of Neurology, Rutgers - Robert Wood Johnson Medical School, 125 Paterson Street, Suite #2200, New Brunswick, NJ 08901, USA.
authors: Stephen
authors: S
authors: Wong
keywords: Depression; Education; Epilepsy; Impulsive–aggressive behavior; Levetiracetam; Psychiatric adverse effect; Suicide attempt; Therapeutic drug monitoring; Traumatic brain injury