Irritability levetiracetam

Psychiatric adverse events, most often hostility and irritability, have been reported in children taking levetiracetam. Four cases of acute psychosis have also been reported (448). 

In a retrospective evaluation of 130 children with intractable epilepsy who had at least four seizures per month and had been treated with levetiracetam, nine reported mild-to-moderate adverse events, but only five dropped out the reason for discontinuation was excessive irritability in three patients and increased aggressiveness in the other two [201 ]. The most common complaints were irritabUity in 6/130 patients, additional aggressive behavior in two, and somnolence in one. 

In 152 children in an open, long-term study of levetiracetam as adjunctive therapy for partial-onset seizures the mean maintenance dose was 56 mg/kg/day and the median treatment duration was 287 days [204 ]. At least one adverse event was reported in 143 patients (94%) the most common were convulsions (25/152 16%), irritability (19/152 13%), and somnolence (16/152 11%). 

In a prospective multicenter, open, addon study, 33 children aged 4-16 years with refractory epilepsy were given levetira-cetam in addition to their previous treatment regimen [180. The retention rate was 70% after 26 weeks, with a median levetiracetam dosage of 22 mg/kg/day. Most reported adverse effects were hyperactivity (49%), somnolence (36%), irritability (33%), and aggressive behavior (27%). 

Drug formulations Extended-release levetiracetam Once-daily extended-release levetiracetam as add-on therapy in relractory partial-onset seizures has been evaluated in a 12 week, double-blind, randomized, placebo-controlled trial in 158 patients [204. There were adverse events in 41 (53%) of those who used extended-release leve-tira-cetam and in 43 (54%) of those who used placebo the most common were somnolence, influenza, irritability, nasopharyngitis, dizziness, and nausea. 

In a retrospective analysis of 118 intravenous infusions of levetiracetam in 15 children with epilepsy, most of whom were aged under 4 years, the following adverse effects were noted during the post-infusion period lethargy n = 2), agitation (1), irritability (1), mild tremors (1), and ataxia (1) no adverse effects required drug withdrawal [207. Three patients had reductions in white blood cell counts within the first 4 days after administration of the first dose of levetiracetam. 

A study of the efficacy and tolerability of levetiracetam in patients with intractable epilepsy in Israel reported no side effects in 62% of participants. Irritability and impulsiveness occurred in 26.9%. Physical side effects including primarily fatigue and astiienia occurred in 16% [88 ]. 

An observational study of 103 pafienfs was performed to assess cognition and behavior in children taking levetiracetam. Ninety-four patients reported adverse events, of which 47 were drug-relafed and included headache (8.7%), irritability (7.8%), aggression (6.8%), fatigue (4.9%), convulsion (3.9%), and abnormal behavior (3.9%) [91 ]. Nineteen (18.5%) patients experienced behavioral problems such as irritability, aggression, or abnormal behavior, which were attributed to levetiracetam. 

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