Abstracts

Rationale: Levetriacetam is a new antiepileptic agent, which has relatively few side effects. It is known to cause neuropsychiatric complications, and often leads intolerance to treatment. However, relationship of its serum level and these neuropsychiatric complications is unknown. We report clinical presentation of levetriacetam side effects and whether it is shows correlation with serum drug level.Methods: From epilepsy patients who visited a tertiary epilepsy center, and were prescribed with levetriacetam between October 2010 and March 2012, basic demographics and clinical information including levetriacetam side effects were collected. Some of the patients checked serum levetriactam level during this period. Retrospectively, we performed a statistical analysis of this data.Results: A total of 560 patients were enrolled. Mean age was 33.1 12.73 year old and 291 (52.0%) were male. More than half or the patients (N=331, 55.5%) complained of at least one adverse effects. Neuropsychiatric complications, defined as irritability, depression and psychosis, were reported in 160 (28.6%) patients, details were irritability in 135 patients, dizziness in 112 patients, somnolence and headache in 64 patients each, depression in 39 patients, and psychosis in 6 patients. Univariate analysis revealed longer duration from seizure onset in the neuropsychiatric complication group with significance (p = 0.031). Previous history of mood disorder was correlated with neuropsychiatric complications (p = 0.004). Levetriacetam serum level was checked in 191 patients, and the mean serum level was 17.66 10.85mcg/ml (reference value of 12.0 to 46.0mcg/ml, Patsalos et. al.). There was no significant difference in mean levetriacetam serum level between neuropsychiatric complication group (16.09 10.88mcg/ml) and no neuropsychiatric complication group (18.39 10.80mcg/ml, p = 0.173).Conclusions: In our study, more than half of the patients who were taking levetiracetam presented with adverse effects. Especially, 28.6% of patients complained of psychiatric adverse effects, which shows similar result with some previous studies. There was no statistical evidence of relationship between neuropsychiatric complications and levetriacetam serum level.