title: Self-reported aggressiveness during treatment with levetiracetam correlates with depression.
abstract: OBJECTIVE
  The purpose of this study was to identify clinical correlates of self-reported aggressiveness (SRA) in patients with epilepsy treated with levetiracetam (LEV) with special reference to the role of depression.
  
  
  METHODS
  A consecutive sample of adult outpatients with epilepsy was assessed with the Neurological Disorder Depression Inventory for Epilepsy, the Adverse Event Profile (AEP), and the Emotional Thermometer.
  
  
  RESULTS
  From a total sample of 163 consecutive patients treated with LEV, SRA at any level (from rarely a problem to always) was associated with a 7-fold increased risk of being depressed (95% CI: 3.0-17.5; p<0.001). Self-reported aggressiveness was reported as "always" a problem by 9.8% of the patients. In these patients, apart from depression, SRA was associated with high AEP total scores (55.1 vs. 39.3; p<0.001) and polytherapy (43.8% vs. 19.8%; p=0.034). Anxiety scores were not elevated (4.9 vs. 3.6; p=0.183).
  
  
  CONCLUSIONS
  Self-reported aggressiveness during treatment with LEV is not an isolated symptom but is associated with depressed mood. Anxiety-mediated mechanisms do not seem to be involved.
authors.affiliation: Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St George's Hospital, London, UK; Institute of Medical and Biomedical Sciences, St George's University of London, UK. Electronic address: mmula@sgul.ac.uk.
authors.forename: Marco
authors.initials: M
authors.lastname: Mula
authors.affiliation: Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St George's Hospital, London, UK; Institute of Medical and Biomedical Sciences, St George's University of London, UK; Department of Neuropsychiatry, South West London & St George's Mental Health Trust, London, UK.
authors.forename: Niruj
authors.initials: N
authors.lastname: Agrawal
authors.affiliation: Department of Neuropsychiatry, South West London & St George's Mental Health Trust, London, UK.
authors.forename: Zainab
authors.initials: Z
authors.lastname: Mustafa
authors.affiliation: Department of Neuropsychiatry, South West London & St George's Mental Health Trust, London, UK.
authors.forename: Krithika
authors.initials: K
authors.lastname: Mohanalingham
authors.affiliation: Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St George's Hospital, London, UK; Institute of Medical and Biomedical Sciences, St George's University of London, UK.
authors.forename: Hannah R
authors.initials: HR
authors.lastname: Cock
authors.affiliation: Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St George's Hospital, London, UK; Institute of Medical and Biomedical Sciences, St George's University of London, UK.
authors.forename: Dora A
authors.initials: DA
authors.lastname: Lozsadi
authors.affiliation: Department of Neurology, Wagner-Jauregg Neuroscience Centre, Kepler Universitätsklinik, Linz, Austria.
authors.forename: Tim J
authors.initials: TJ
authors.lastname: von Oertzen
mesh_terms: D000328:Adult; D000374:Aggression / Q000523:psychology*; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000139:chemically induced* / Q000523:psychology*; D004827:Epilepsy / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D057566:Self Report; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam
keywords: Adverse events; Aggressive behavior; Aggressiveness; Antiepileptic drugs; Depression; Epilepsy; Levetiracetam