NEUROPSYCHIATRIC COMPLICATIONS OF LEVETIRACETAM IN CHILDREN WITH EPILEPSY
Abstract number :
1.154
Submission category :
Year :
2002
Submission ID :
875
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Guillermo Estrada, Diane Wildrick, Michael Pranzatelli. Pediatrics and Neurology, Southern Illinois University School of Medicine, Springfield, IL
RATIONALE: To investigate the safety of levitiracetam in children with epilepsy.
: At the end of this presentation participants should be able to identify children with comorbid conditions who would not be good candidates for treatment with levetiracetam.
METHODS: We reviewed charts to identify children with epilepsy on levetiracetam.
RESULTS: Of 22 children, 8 were on levetiracetam monotherapy. The rest were on combination therapy (zonisamide, divalproex sodium, topiramate, lamotrigine, clonazepam, oxcarbazepine, carbamazepine, phenytoin and ketogenic diet). Only 4 were taking 3 or more AEDs.The mean age was 12.5 yrs. (SD 4.2), range 4 to 19 yrs. Eleven were males and eleven were females. Thirteen had partial seizures, 8 generalized seizures, and 1 benign rolandic epilepsy. 73% had ADHD, developmental delay, cerebral palsy, mental retardation, learning disabilities, or oppositional defiant disorder. Mean dosage was 35mg/kg/d (SD 13), range 11 to 55. Duration of treatment was 1 week to 25 months, mean 9.8 (SD 8.6). 68% had behavioral side effects including aggressive behavior, suicidal ideations, and depression, which required stopping the drug. 80% of them had prior psychiatric symptoms. Even in the absence of neuropsychiatric disorders, 50% of the children with epilepsy on levetiracetam developed behavioral changes.All abnormalities were reversible.
CONCLUSIONS: Levetiracetam is associated with high incidence of psychiatric symptoms in children with epilepsy. Preselection of children to avoid comorbid neuropsychiatric disorders is important to the safe use of this drug.