J Clin Neurol.  2011 Sep;7(3):128-136. 10.3988/jcn.2011.7.3.128.

Psychiatric Symptoms and Quality of Life in Patients with Drug-Refractory Epilepsy Receiving Adjunctive Levetiracetam Therapy

Affiliations
  • 1Department of Neurology, Daegu Fatima Hospital, Daegu, Korea.
  • 2Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea. sppark@mail.knu.ac.kr

Abstract

BACKGROUND AND PURPOSE
Levetiracetam (LEV) is a new antiepileptic drug that has been found to be effective as an adjunctive therapy for uncontrolled partial seizures. However, the results of several studies suggested that LEV has negative psychotropic effects, including irritability, aggressiveness, suicidality, and mood disorders. We investigated the impact of adjunctive LEV on psychiatric symptoms and quality of life (QOL) in patients with drug-refractory epilepsy (DRE) and determined the risk factors provoking psychiatric adverse events.
METHODS
A 24-week, prospective, open-label study was conducted. At enrollment, we interviewed patients and reviewed their medical charts to collect demographic and clinical information. They were asked to complete self-report health questionnaires designed to measure various psychiatric symptoms and QOL at enrollment and 24 weeks later.
RESULTS
Seventy-one patients were included in the study, 12 patients (16.9%) of whom discontinued LEV therapy due to serious adverse events including suicidality. The risk factor for premature withdrawal was a previous history of psychiatric diseases (odds ratio 4.59; 95% confidence interval, 1.22-17.32). LEV intake resulted in significant improvements in Beck Anxiety Inventory score (p<0.01) and some domains of the Symptom Checklist-90-Revised, such as somatization (p<0.05), obsessive-compulsiveness (p<0.05), depression (p<0.05), and anxiety (p<0.05). These improvements were not related to the occurrence of seizure freedom. The Quality of Life in Epilepsy Inventory-31 overall score and subscale scores, such as seizure worry (p<0.01), overall QOL (p<0.05), emotional well-being (p<0.05), energy-fatigue (p<0.05), and social function (p<0.05), also improved.
CONCLUSIONS
Adjunctive LEV in patients with DRE is likely to improve psychiatric symptoms and QOL. Clinicians should be well aware of the psychiatric histories of patients to prevent them from developing serious adverse events related to LEV.

Keyword

drug refractory; epilepsy; levetiracetam; psychiatric symptoms; suicide; quality of life

MeSH Terms

Anxiety
Depression
Epilepsy
Freedom
Humans
Mood Disorders
Piracetam
Prospective Studies
Quality of Life
Risk Factors
Seizures
Suicide
Surveys and Questionnaires
Piracetam

Cited by  1 articles

Depression and Anxiety in People with Epilepsy
Oh-Young Kwon, Sung-Pa Park
J Clin Neurol. 2014;10(3):175-188.    doi: 10.3988/jcn.2014.10.3.175.


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