Abstracts

Levetiracetam is a newer antiepileptic drug which has proven useful for add-on and monotherapy in pediatric refractory epilepsy. Behavioral problems have been reported including irritability, mood swings, and depression. Sometimes underlying behavioral problems predated starting the levetiracetam. This side effect profile has sometimes led to discontuation of the drug even when it was effective for epilepsy control. There have been prior anecdotal reports of vitamin B6 (Pyridoxine) helping this behavioral problem in some patients. This led to trying this as first line treatment for patients treated with levetiracetam who developed these behavioral complaints. A retrospective chart review was done analyzing whether the addition of vitamin B6 helped these behavioral symptoms. 21 consecutive patients started on levetiracetam (average dose 313mg/day) were observed for behavioral side effects and if they occurred vitamin B6 was started. The charts charts of these patients were retrospectively reviewed to see how many children had responded. The results showed 12/16 patients improved behaviors (2 patients did not improve, 2 did not have enough data to conclude effectiveness). There were 9 females/7 males with average age 8.16 years (range 3-21 years). Average dosage was 313 mg/day for levetiracetime. Average vitamin B6 dosage was 118mg/day (range 50-400mg/day). This retrospective chart review looked at behavioral side effects from levetiracetam and the treatment by addition of vitamin B6 to treat this reported problem. This study showed a 75% response rate in this pediatric series. This warrants a controlled prospective trial of vitamin B6 in the future in patients with behavioral side effects of this anticonvulsant. (Supported by Investigator Initiated Grant from UCB Pharma.)