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Background We interviewed college students who engage in prescription stimulant misuse and diversion to better understand perspectives on prevention and intervention strategies. Methods Trained student researchers at one southern California university completed 32 face-to-face interviews with students who had a history of misuse and/or diversion. Participants provided insights on programs, policies, and practices that have the potential to deter behavior. Data were analyzed inductively via thematic analysis. Results Students were often misinformed or unaware of existing programs, policies and practices. Additionally, some students felt their behaviors would not be detected, whereas other students felt the fear of being detected would lead them to change their behaviors. Harm reduction and treatment-based approaches to address misuse were also recommended. Conclusions Our findings emphasize the importance of better educating students about, and enforcing, existing policies. In addition, the need to better inform students of existing campus programs is warranted.

Introduction: Comparative studies prove that levetiracetam therapy presents a major frequency of behavioral disturbances, producing problems of impulsive aggressiveness with a relative frequency. Principally if a previous psychiatric history is associated. Objetives: Report a case of Impulsive homicide aggression in a patient treated with Levetiracetam.Extensive bibliographical review. Methods: We describe the case of a patient admitted in our Psychiatric acute unit because a major depressive disorder and mild cognitive impairment associated with vascular factors that developed strange impulsive aggressive behavior after the initiation of treatment with levetiracetam, even to try to assassinate his wife. Follow-up visits were performed at 6 and 12 months after discharge to assess aggressive behavior and the change in the Barratt impulsivity scale and the hostility inventory of Buss-Durkee. We conducted a literature review of behavioral and aggression problems associated with treatment with levetiracetam and its possible mechanisms. Results: After the phasing out of levetiracetam and replacement by oxcarbazepine, aggressive behaviors disappeared. No significant psychopathology was showed in the patient in the follow-up visits, except secondary to preexisting cognitive impairment. Conclusions: According to studies reviewed a 7-13% of patients treated with levetiracetam may develop behavioral disorders with impulsive aggression that usually resolve after discontinuation of drug. Comparative studies show that levetiracetam has a greater frequency of such effects, leading to problems of impulsive aggression relatively often, especially if there is a comorbid psychiatric pathology.

We used the narrative vignette/storytelling approach to provide a holistic illustration of prescription stimulant misuse [PSM] and diversion [PSD] initiation and maintenance among college-attending emerging adults. We conducted 32 semi-structured, theory-guided interviews with 20 students during spring and summer 2019. The participants were diverse with respect to age, race/ethnicity and gender, and had a history of PSM and/or PSD. We created four narrative vignettes using a multi-step, collaborative process that incorporated patterns of what contributed to initiation and maintenance for four identified student groups (i.e., PSM with and without a prescription and PSD with and without a prescription). Characteristics of the individual, social and broader environments influenced behavior initiation, and positive reinforcement from trial behavior contributed to maintenance. Similarities and differences were identified across the groups. Approaches for PSM and PSD prevention and intervention in college-attending emerging adults should be multifaceted and consider prescription status.

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