Abstracts

Rationale: Interictal depression is common in patients with epilepsy and it significantly impacts quality of life. Levetiracetam (LEV) is an antiepileptic drug with a broad spectrum of efficacy in epilepsy. The initial pharmacologic studies with LEV explored its ability to facilitate cholinergic neurotransmission. LEV main mechanism of action is unique and related to the binding of SV2A protein on the synaptic vesicle. LEV appears able to control pathologic neuronal hyper excitability through a modulatory inhibition of neuronal high-voltage Ca++ currents. Some studies indicate that LEV may have stabilizing properties. The current study was undertaken to evaluate the effects of LEV on mood in patients with depressive symptomatology. Methods: Twenty-five adults with uncontrolled partial seizures and concomitant depressive symptomatology were evaluated using measures of depression (Montgomery and Asberg Depression Rating Scale [MADRS], Hamilton Depression Rating Scale [HDRS], Zung Self-rating Scale for Depression [Z-SDS]) and anxiety (Hamilton Anxiety Rating Scale [HARS], Zung Self-rating Scale for Anxiety [Z-SAS]) to test the effects of LEV on mood. Results: Evaluations after 5 weeks and after 3 months of LEV treatment demonstrated significant improvement in depression and anxiety. Patients in this study showed significant improvements in depression, as measured by MADRS. Week 5 score was significantly reduced in comparison to baseline (P=0.001). Overall score at 3-month evaluation was also significantly reduced in comparison to baseline (P=0.010). Overall scores for HDRS, Z-SDS, HARS, Z-SAS at baseline were compared with the overall score at Week 5. The Week 5 scores were significantly reduced in comparison to baseline. Overall scores at 3-month evaluation were also significantly reduced in comparison to baseline. The results of the study suggest that LEV may also have a favourable effect on anxiety, as measured by HARS an Z-SAS. Conclusions: Because antiepileptic drugs can affect mood, psychotropic properties must be considered in addition to anticonvulsant efficacy in selecting these drugs. This uncontrolled study suggests that treatment with LEV may also improve depression and anxiety in patients with partial seizures. Besides, LEV treatment seem to be safe and well-tolerated. However, the sample of patients is limited and the possibility of a placebo effect cannot be excluded. These findings must be considered preliminary and should be replicated under placebo-controlled conditions.