Levetiracetam Induced Behavioral Abnormalities in a Patient with Seizure Disorder: A Diagnostic Challenge
Levetiracetam is a second-generation antiepileptic drug that is chemically unrelated to other antiepileptic drugs. Levetiracetam is a broad-spectrum antiseizure medication that is approved as an adjunctive therapy in the treatment of partial and generalized tonic-clonic seizures in children and adul...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Case Reports in Psychiatry |
| Online Access: | http://dx.doi.org/10.1155/2020/8883802 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832568558871117824 |
|---|---|
| author | Oluwaseun Ogunsakin Terence Tumenta Scarlet Louis-Jean Ayesha Mahbub Peterson Rabel Tolu Olupona Shaheen Alam |
| author_facet | Oluwaseun Ogunsakin Terence Tumenta Scarlet Louis-Jean Ayesha Mahbub Peterson Rabel Tolu Olupona Shaheen Alam |
| author_sort | Oluwaseun Ogunsakin |
| collection | DOAJ |
| description | Levetiracetam is a second-generation antiepileptic drug that is chemically unrelated to other antiepileptic drugs. Levetiracetam is a broad-spectrum antiseizure medication that is approved as an adjunctive therapy in the treatment of partial and generalized tonic-clonic seizures in children and adults with epilepsy. The mechanism by which Levetiracetam induces behavioral changes remains unknown. Its proposed mechanism of action involves binding to synaptic vesicle protein 2A (SV2A) and this leads to neuronal inhibition. Though, the drug has a convenient dosing regimen and is relatively well tolerated, neuropsychiatric side effects can emerge beyond the initial titration period and may be the most common reason for drug discontinuation. Levetiracetam has been reported to cause varying degrees of psychiatric adverse effects including behavioral disturbance such as agitation, hostility and psychosis, and mood symptoms and suicidality. It has been shown to induce psychiatric side effects in 13.3% of adults, with only 0.7% presenting with severe symptoms such as depression, agitation, or hostility. The prevalence rate of development of psychosis in these patients is estimated to be about 1.4%. A review of literature has demonstrated a relative correlation between Levetiracetam use and the development of neurobehavioral symptoms which is increased in predisposed individuals. This research describes the case of a 28-year-old woman with seizure disorder and a psychiatric history of schizoaffective disorder who developed aggressive behavior, paranoia, and severe hostility following administration of Levetiracetam 750 mg orally twice daily. She developed acute behavioral symptoms which were reversed with cessation of Levetiracetam. This report emphasizes the need for developing an appropriately high index of suspicion in promoting surveillance and prompt identification of behavioral adverse effects associated with Levetiracetam especially in high-risk patient population. |
| format | Article |
| id | doaj-art-36c1452f635441bc99ec2f6859eaaf29 |
| institution | Kabale University |
| issn | 2090-682X 2090-6838 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Psychiatry |
| spelling | doaj-art-36c1452f635441bc99ec2f6859eaaf292025-02-03T00:58:44ZengWileyCase Reports in Psychiatry2090-682X2090-68382020-01-01202010.1155/2020/88838028883802Levetiracetam Induced Behavioral Abnormalities in a Patient with Seizure Disorder: A Diagnostic ChallengeOluwaseun Ogunsakin0Terence Tumenta1Scarlet Louis-Jean2Ayesha Mahbub3Peterson Rabel4Tolu Olupona5Shaheen Alam6Department of Psychiatry, Interfaith Medical Center, Brooklyn NY 11213, USADepartment of Psychiatry, Interfaith Medical Center, Brooklyn NY 11213, USAAmerican University of Antigua College of Medicine, New York, NY 10004, USADepartment of Psychiatry, Interfaith Medical Center, Brooklyn NY 11213, USADepartment of Psychiatry, Interfaith Medical Center, Brooklyn NY 11213, USADepartment of Psychiatry, Interfaith Medical Center, Brooklyn NY 11213, USADepartment of Psychiatry, Interfaith Medical Center, Brooklyn NY 11213, USALevetiracetam is a second-generation antiepileptic drug that is chemically unrelated to other antiepileptic drugs. Levetiracetam is a broad-spectrum antiseizure medication that is approved as an adjunctive therapy in the treatment of partial and generalized tonic-clonic seizures in children and adults with epilepsy. The mechanism by which Levetiracetam induces behavioral changes remains unknown. Its proposed mechanism of action involves binding to synaptic vesicle protein 2A (SV2A) and this leads to neuronal inhibition. Though, the drug has a convenient dosing regimen and is relatively well tolerated, neuropsychiatric side effects can emerge beyond the initial titration period and may be the most common reason for drug discontinuation. Levetiracetam has been reported to cause varying degrees of psychiatric adverse effects including behavioral disturbance such as agitation, hostility and psychosis, and mood symptoms and suicidality. It has been shown to induce psychiatric side effects in 13.3% of adults, with only 0.7% presenting with severe symptoms such as depression, agitation, or hostility. The prevalence rate of development of psychosis in these patients is estimated to be about 1.4%. A review of literature has demonstrated a relative correlation between Levetiracetam use and the development of neurobehavioral symptoms which is increased in predisposed individuals. This research describes the case of a 28-year-old woman with seizure disorder and a psychiatric history of schizoaffective disorder who developed aggressive behavior, paranoia, and severe hostility following administration of Levetiracetam 750 mg orally twice daily. She developed acute behavioral symptoms which were reversed with cessation of Levetiracetam. This report emphasizes the need for developing an appropriately high index of suspicion in promoting surveillance and prompt identification of behavioral adverse effects associated with Levetiracetam especially in high-risk patient population.http://dx.doi.org/10.1155/2020/8883802 |
| spellingShingle | Oluwaseun Ogunsakin Terence Tumenta Scarlet Louis-Jean Ayesha Mahbub Peterson Rabel Tolu Olupona Shaheen Alam Levetiracetam Induced Behavioral Abnormalities in a Patient with Seizure Disorder: A Diagnostic Challenge Case Reports in Psychiatry |
| title | Levetiracetam Induced Behavioral Abnormalities in a Patient with Seizure Disorder: A Diagnostic Challenge |
| title_full | Levetiracetam Induced Behavioral Abnormalities in a Patient with Seizure Disorder: A Diagnostic Challenge |
| title_fullStr | Levetiracetam Induced Behavioral Abnormalities in a Patient with Seizure Disorder: A Diagnostic Challenge |
| title_full_unstemmed | Levetiracetam Induced Behavioral Abnormalities in a Patient with Seizure Disorder: A Diagnostic Challenge |
| title_short | Levetiracetam Induced Behavioral Abnormalities in a Patient with Seizure Disorder: A Diagnostic Challenge |
| title_sort | levetiracetam induced behavioral abnormalities in a patient with seizure disorder a diagnostic challenge |
| url | http://dx.doi.org/10.1155/2020/8883802 |
| work_keys_str_mv | AT oluwaseunogunsakin levetiracetaminducedbehavioralabnormalitiesinapatientwithseizuredisorderadiagnosticchallenge AT terencetumenta levetiracetaminducedbehavioralabnormalitiesinapatientwithseizuredisorderadiagnosticchallenge AT scarletlouisjean levetiracetaminducedbehavioralabnormalitiesinapatientwithseizuredisorderadiagnosticchallenge AT ayeshamahbub levetiracetaminducedbehavioralabnormalitiesinapatientwithseizuredisorderadiagnosticchallenge AT petersonrabel levetiracetaminducedbehavioralabnormalitiesinapatientwithseizuredisorderadiagnosticchallenge AT toluolupona levetiracetaminducedbehavioralabnormalitiesinapatientwithseizuredisorderadiagnosticchallenge AT shaheenalam levetiracetaminducedbehavioralabnormalitiesinapatientwithseizuredisorderadiagnosticchallenge |