Abstracts

Rationale: Anti-seizure medications (ASM) have been proven to be effective in their role of controlling seizures; however, ASM use is often limited due to the behavioral and psychiatric adverse effects associated with them. This is a primary concern with levetiracetam, as neuropsychiatric adverse effects (NSAE) may be the most common reason for drug discontinuation. To further help in facilitating management and reducing the risks of NSAE, knowledge of the clinical and demographic predictors of mood and behavioral adverse effects from levetiracetam use may deem helpful.

Methods: This was a single center retrospective analysis including adults with epilepsy who followed in the outpatient clinic at UF Health Jacksonville between March 2021 and September 2022. Inclusion criteria was age 18-64 years of age, a diagnosis of epilepsy, and current or previous treatment with levetiracetam. Exclusion criteria included a non-epileptic spell history (or pseudoseizures), levetiracetam use of ≤7 days, or suicidality (ideation or attempt). Demographic and clinical variables collected included (but was not limited to) age, sex, race/ethnicity, epilepsy type and seizure control. Levetiracetam associated NSAE were grouped into three categories: (1) behavioral/ mood, (2) disturbed sleep/mentation, and (3) other. For statistical analysis, the presence of NSAE (yes or no) was our outcome of interest. Bivariate statistical tests between the outcome of interest and sex, epilepsy type, and race/ethnicity were conducted using the chi-squared test.

Results: 436 subjects were included in this study (Table 1). 51 subjects were unable to tolerate levetiracetam, as determined by a dosage reduction or discontinuation of the medication (Table 2). The most common reason for discontinuing levetiracetam was behavioral and mood effects. Hispanic ethnicity was associated with neuropsychiatric drug intolerability (p-value = < 0.05); however, no significance was seen for gender (p-value = 0.28) or epilepsy type (p-value = 0.43).