Abstracts

Rationale: Non-physical aggressive behavior has been reported in patients who were treated with Levetiracetam for seizure disorder. We report two cases of physical aggression associated with Levetiracetam (LEV)Methods: We retrospectively reviewed the medical records of patients who were treated at our epilepsy center with Levetiracetam for seizure disorder between January 2004 and December2006Results: 145 patients were treated with levetiracetam for seizure disorders. We identified two cases who developed physical aggression in the course of treatment. One patient was a 30 year-old woman with primary generalized epilepsy who was placed on LEV in addition to valproate to improve seizure control. Two weeks after initiation of LEV treatment, patient developed rapidly increasing aggressive behavior and subsequently progressed to physical aggression towards her husband, requiring police intervention. The second patient was a 35 year-old woman with drug resistant right temporal lobe epilepsy who developed physical aggressive behavioral towards coworker 3 weeks after she was started on LEV in addition to Carbamazepine. In this case police were also called in. None of the victims sustained serious injury. None of the patients has had history of aggressive behavior, psychiatric conditions or interical or postictal psychosis. In both cases, LEV was discontinued and patients never experienced such behavior againConclusions: These clinical observations demonstrated the possibility of subacutely and expectedly developing physical aggression early in the course of treatment with LEV. None of the patients has risk factors for developing aggression as it has been reported in many patients with pre-existing conditions such as intellectual disability and history of aggressive behavior. It is recommended that patients, their family or caregivers be informed about the possibility of developing such a potentially serious adverse drug reaction