Marco Mula1, Niruj Agrawal2, Zainab Mustafa3, Krithika Mohanalingham3, Hannah R Cock4, Dora A Lozsadi4, Tim J von Oertzen5. 1. Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St George's Hospital, London, UK; Institute of Medical and Biomedical Sciences, St George's University of London, UK. Electronic address: mmula@sgul.ac.uk. 2. Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St George's Hospital, London, UK; Institute of Medical and Biomedical Sciences, St George's University of London, UK; Department of Neuropsychiatry, South West London & St George's Mental Health Trust, London, UK. 3. Department of Neuropsychiatry, South West London & St George's Mental Health Trust, London, UK. 4. Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St George's Hospital, London, UK; Institute of Medical and Biomedical Sciences, St George's University of London, UK. 5. Department of Neurology, Wagner-Jauregg Neuroscience Centre, Kepler Universitätsklinik, Linz, Austria.
Abstract
PURPOSE: The purpose of this study was to identify clinical correlates of self-reported aggressiveness (SRA) in patients with epilepsy treated with levetiracetam (LEV) with special reference to the role of depression. METHODS: A consecutive sample of adult outpatients with epilepsy was assessed with the Neurological Disorder Depression Inventory for Epilepsy, the Adverse Event Profile (AEP), and the Emotional Thermometer. RESULTS: From a total sample of 163 consecutive patients treated with LEV, SRA at any level (from rarely a problem to always) was associated with a 7-fold increased risk of being depressed (95% CI: 3.0-17.5; p<0.001). Self-reported aggressiveness was reported as "always" a problem by 9.8% of the patients. In these patients, apart from depression, SRA was associated with high AEP total scores (55.1 vs. 39.3; p<0.001) and polytherapy (43.8% vs. 19.8%; p=0.034). Anxiety scores were not elevated (4.9 vs. 3.6; p=0.183). CONCLUSIONS: Self-reported aggressiveness during treatment with LEV is not an isolated symptom but is associated with depressed mood. Anxiety-mediated mechanisms do not seem to be involved.
PURPOSE: The purpose of this study was to identify clinical correlates of self-reported aggressiveness (SRA) in patients with epilepsy treated with levetiracetam (LEV) with special reference to the role of depression. METHODS: A consecutive sample of adult outpatients with epilepsy was assessed with the Neurological Disorder Depression Inventory for Epilepsy, the Adverse Event Profile (AEP), and the Emotional Thermometer. RESULTS: From a total sample of 163 consecutive patients treated with LEV, SRA at any level (from rarely a problem to always) was associated with a 7-fold increased risk of being depressed (95% CI: 3.0-17.5; p<0.001). Self-reported aggressiveness was reported as "always" a problem by 9.8% of the patients. In these patients, apart from depression, SRA was associated with high AEP total scores (55.1 vs. 39.3; p<0.001) and polytherapy (43.8% vs. 19.8%; p=0.034). Anxiety scores were not elevated (4.9 vs. 3.6; p=0.183). CONCLUSIONS: Self-reported aggressiveness during treatment with LEV is not an isolated symptom but is associated with depressed mood. Anxiety-mediated mechanisms do not seem to be involved.
Authors: Vincenzo Belcastro; Laura Rosa Pisani; Silvio Bellocchi; Paolo Casiraghi; Gaetano Gorgone; Marco Mula; Francesco Pisani Journal: J Neurol Date: 2017-03-18 Impact factor: 4.849
Authors: Martin J Brodie; Frank Besag; Alan B Ettinger; Marco Mula; Gabriella Gobbi; Stefano Comai; Albert P Aldenkamp; Bernhard J Steinhoff Journal: Pharmacol Rev Date: 2016-07 Impact factor: 25.468