Self-reported feelings of anger and aggression towards others in patients on levetiracetam: data from the UK antiepileptic drug register

Abstract

ObjectivesTo ascertain the frequency of self-reported anger and depression in levetiracetam (LEV).DesignWe compared patients with epilepsy (PWE) taking LEV with PWE taking other antiepileptic drugs (AEDs).SettingAll PWE and controls submitted information to the UK AED register.ParticipantsWe analysed the data of 418 PWE and 41 control participants. 158 participants took LEV in monotherapy or as part of polypharmacotherapy, 260 PWE took other AED.Primary and secondary outcome measuresAll PWE and controls completed the Liverpool Adverse Event Profile (LAEP) which includes items on anger and depression quantified on a four-point Likert scale, with 1 indicating that there was never a problem; 2, rarely a problem; 3, sometimes a problem and 4, always or often a problem.Results49% of PWE on LEV and 39% on AED other than LEV reported anger as sometimes or always being a problem (p=0.042). 48% of PWE on LEV and 45% on AED other than LEV reported depression as sometimes or always being a problem (p=0.584). 7% of control participants reported anger as sometimes being a problem and 93% reported anger as never or rarely being a problem. Depression was never a problem in 75% of controls and rarely a problem in 25%.ConclusionsAnger and depression were more frequently reported as a problem by PWE than by control participants. Our observational register of self-reported symptoms suggested anger being more often a problem in patients taking LEV than in PWE taking other AED. PWE should be informed about this potential problem of LEV.

Subjectively Perceived Side-Effects of Anti-Epileptic Drugs in Chronic Refractory Epilepsy

“…The mood complaints of patients using LEV treatment were an essential factor in our study and are in line with a number of studies and meta-analyses [27][28][29][30]. LEV had an adverse event profile within the range of the other older drugs like PHT but with a different profile; self-reported anger and hostility were particularly frequent [13,15].…”

“…This concurs with the patient-reported cognitive side-effects that are more common with TPM, followed by ZNS and phenytoin (PHT) and are least likely to be reported with GBP, valproate (VPA), LTG and carbamazepine (CBZ) [10,11]. Furthermore, the newer anti-epileptic drug LEV is known for its high-risk to cause mood effects [12,13]. Mood side-effects are therefore most common in patients-reports with (LEV) [14,15].…”

Adjunctive perampanel in adolescents with inadequately controlled partial‐onset seizures: A randomized study evaluating behavior, efficacy, and safety

“…11 Thus, given the potential for AEDs to negatively impact behavior, in particular aggressive behavior, 12,13 it is essential that behavioral safety profiles of AEDs in the pediatric setting are fully characterized.…”

Foreground and background: an interview with Peter Singer and three arguments against naturalism

“…In previous studies (Glauser et al, 2016;Snoijen-Schouwenaars et al, 2017), polypharmacy did not predict an increased probability of occurrence of side effects, including psychiatric AEs. In our study, 5/12 patients who developed aggressiveness took levetiracetam, a drug which has been reported to be associated with aggressive behavior (Dinkelacher et al, 2003;Wieshmann and Baker, 2013). In addition, pharmacodynamic interactions between levetiracetam and PER have been suggested (Patsalos et al, 2015).…”