Elisabeth Halma1, Anton J A de Louw2, Sylvia Klinkenberg3, Albert P Aldenkamp4, Dominique M IJff5, Marian Majoie6. 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.
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.
Authors: David W Loring; Kimford J Meador; Shlomo Shinnar; William Davis Gaillard; James W Wheless; Sudha K Kessler; Joan A Conry; Madison M Berl; Thomas G Burns; Tracy A Glauser; Becky Kinkead; Avital Cnaan Journal: Epilepsy Behav Date: 2019-12-06 Impact factor: 2.937
Authors: Mark A Kramer; Lauren M Ostrowski; Daniel Y Song; Emily L Thorn; Sally M Stoyell; McKenna Parnes; Dhinakaran Chinappen; Grace Xiao; Uri T Eden; Kevin J Staley; Steven M Stufflebeam; Catherine J Chu Journal: Brain Date: 2019-05-01 Impact factor: 13.501
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Authors: Dan Y Song; Sally M Stoyell; Erin E Ross; Lauren M Ostrowski; Emily L Thorn; Steven M Stufflebeam; Amy K Morgan; Britt C Emerton; Mark A Kramer; Catherine J Chu Journal: Brain Behav Date: 2019-02-20 Impact factor: 2.708