LEVETIRACETAM UTILITY IN AUTISTIC CHILDREN LIMITED BY BEHAVIORAL SIDE EFFECTS
Abstract number :
2.183
Submission category :
Year :
2003
Submission ID :
3976
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Katherine M. Martien Pediatrics, Massachusetts General Hospital, Boston, MA
A pilot study of Levetiracetam (Keppra) in non-verbal autistic children was undertaken to determine whether this new anticonvulsant would prove efficacious in improving language trajectory.
The pilot cohort consisted of four children (mean age 7.0 yrs, range 5-11 years) with autism (DSM IV criteria, confirmed by ADOs and/or ADI) and profound receptive and expressive language delay. All four had epileptiform EEGs although none showed clinical seizures. One of the four had suffered a regression and met criteria for Landau Kleffner variant. All four were started on Levetiracetam at low dose (62.5-125mg QD) and advanced as tolerated to 250mg BID (up to 20mg/kg/d).
One child was forced to stop the medication after three days due to severe exacerbation of baseline hyperactivity and consuming repetitive stereotypies. Two of the four were forced to stop the medication after two and six months, respectively, due to increased hyperactivity, sensory seeking behavior, and consuming repetitive stereotypies which were dose related. One of these showed significant language and social skill improvements which were lost after the medication was stopped. The fourth child remains on Levetiracetam ten months after initiation. He shows improvement in language, adaptive skills and sleep although increases in sensory seeking behavior and consuming repetitive stereotypies are negatively impacting daily function and have resulted in dosage decrease. Two of the four showed initial motor clumbsiness which resolved over time. No other side effects have been noted.
Utility of Levetiracetam in autistic children may prove limited due to behavioral side effects apparent at low dosages including hyperactivity, exacerbation of sensory seeking/self stimulatory behaviors and consuming repetitive/stereotypic motor behaviors, despite evidence of improvements in language, social reciprocity, adaptive skills and sleep. Both benefits and side effects of Levetiracetam appear to be dose related although idiosyncratic side effects may also be seen.
[Supported by: Harcourt General Charitable Foundation]