Abstracts

RATIONALE: The present study examines aggressive behavior in patients who received Levetiracetam for seizure disorder
METHODS: We retrospectively reviewed medical records of patients who received Levetiracetam for seizure disorder at our epilepsy center between January 2000-Febraury 2002. We included all patients who received Levetiracetam for epilepsy but did not receive any additional antiepileptic drugs during the period of aggressive behavior development. Aggressive behavior is defined here as any significant hostility, verbal, or physical aggression against people or properties as reported by patients, family, caregivers, or school teachers. At the same time, this aggressive behavior must be temporarily correlated with initiation or maintenance periods of Levetiracetam therapy and it required the reduction or discontinuation of Levetiracetam and resolution of aggression. Patients who developed any form of psychosis were not included in this study
RESULTS: We identified 460 patients who received Levetiracetam for localization related epilepsy or generalized epilepsy who fulfilled above criteria for inclusion or exclusion. Age range is 2-84, with mean age of 35 years, 240 females (52%) and 220 males (48%). 18 patients (3.9%, 9 females and 9 males) displayed aggressive behavior requiring the reduction or discontinuation of Levetiracetam. Four males and three females have had a history of aggression in the past (including a female and a male with hypothalamic hamartoma) and four males and six females developed de novo aggression during the treatment period. The mean age of females who developed aggression was 38.9 and for males was 19.1 years
CONCLUSIONS: Levetiracetam related aggression is observed in 3.9% of patients and nearly equally affecting males and females. However, females are more likely than males to develop new onset aggression during treament, whereas males are more likely to develop aggression at a much youger age than females.