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Seizure. 2014 Oct;23(9):685-91. doi: 10.1016/j.seizure.2014.06.004. Epub 2014 Jun 12.

Behavioral side-effects of levetiracetam in children with epilepsy: a systematic review.

Author information

1
Department of Neurology, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands. Electronic address: HalmaI@kempenhaeghe.nl.
2
Department of Neurology, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands. Electronic address: LouwA@kempenhaeghe.nl.
3
Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands. Electronic address: s.klinkenberg@mumc.nl.
4
Department of Behavioral Research and Clinical Neuropsychology, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands; Faculty of Electrical Engineering, University of Technology, Eindhoven, The Netherlands; Department of Neurology, University Hospital Gent, Gent, Belgium. Electronic address: AldenkampB@kempenhaeghe.nl.
5
Department of Behavioral Research and Clinical Neuropsychology, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands. Electronic address: IJffD@kempenhaeghe.nl.
6
Department of Neurology, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands. Electronic address: MajoieM@kempenhaeghe.nl.

Abstract

PURPOSE:

Children with epilepsy are more likely to have behavioral problems compared to children without epilepsy. Literature suggests that levetiracetam leads to behavioral side-effects in children with epilepsy. The objective of this study is to provide a better overview of the frequency and variety of behavioral side-effects, which can be initiated by levetiracetam therapy in children with epilepsy.

METHOD:

Electronic databases used in the search were PubMed, Medline, Cochrane and Embase. Studies were eligible for inclusion when they included children from one month to 18 years of age with a diagnosis of epilepsy, used levetiracetam, had other AEDs on a stable regimen for at least two months, reported about behavioral side-effects and had a follow-up of at least two weeks. Quality assessments and data collection were carried out for all eligible studies.

RESULTS:

Thirteen studies, including 727 patients using levetiracetam, were included in this systematic review. Three randomized controlled trials showed a total of 62 behavioral side-effects in 203 patients, effects which led to discontinuation of levetiracetam in only two of 102 patients (2.0%). Hostility, nervousness and aggression were reported mostly. Meta-analysis showed a statistically significant relative risk of 2.18 for the total number of behavioral side-effects for levetiracetam versus placebo. Observational studies showed mixed results with both behavioral deteriorations and improvements following levetiracetam.

CONCLUSION:

Based on the findings in this systematic review, children using levetiracetam have a risk of developing several behavioral side-effects such as aggression, hostility and nervousness compared to children who do not use levetiracetam.

KEYWORDS:

Anti-epileptic drugs; Behavior; Behavioral problems; Children; Epilepsy; Levetiracetam

PMID:
24981629
DOI:
10.1016/j.seizure.2014.06.004
[Indexed for MEDLINE]
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