Abstracts

In a previous open-label prospective study we evaluated the efficacy of levetiracetam (LEV) treatment in patients with high frequency refractory partial or secondary generalised seizures. The aim of this study was to evaluate the effect of LEV on the potential risk of anxiety or depression development in these patients by using psychiatric rating scales. We evaluated 53 patients (25 female, 28 male), mean age 33.5[plusmn]9.1 years, with refractory partial epilepsy and high frequency partial seizures, mean seizure frequency per month was: SPS (9.7), CPS (17.3) with or without secondary generalisation SGTC (1.1). Patients were recieving one or 2 other AEDs (for at least 4 weeks at stable doses) before commencing LEV as add-on therapy. Our patients were not diagnosed or treated for anxiety or depressive disorder before LEV treatment. In a subgroup of these patients (N=44) we evaluated in detail the presence of [lsquo]de novo[lsquo] anxiety and depressive symptoms (using clinical psychiatric examinations, Hamilton Rating Scales for anxiety HAMA 17 and depression HAMD 21) both at baseline and study end. 48 patients completed the study, a retention rate of 90.5% (48 pts. of ITT=53 pts.), mean daily LEV dose was 2291.7 [plusmn] 617.4 mg.
Seizure freedom was achieved in 21% (N=11) of patients, 49% were responders ([ge]50% seizure frequency reduction), with the main seizure reduction relatively rapid in the first month of therapy.
HAMA 17 and HAMD 21 scores were obtained for 44 patients (of 48 patients who completed the study). A global reduction in HAMA 17 and HAMD 21 scores was seen in all of these 44 patients at study end compared with baseline, responders showing a better improvement.
However, 4.2% (N=2) patients experienced mild [lsquo]de-novo[lsquo] anxiety and depressive symptoms and 4 patients (responders) showed mild signs of irritability and insomnia. Three of these patients were also treated with lamotrigine. There were no psychiatric reasons for LEV treatment discontinuation in any of our patients.
Statistical evaluations will be presented. Our results show that LEV treatment was associated with mood improvement in our patients with frequent partial seizures, mainly in responders.