Systematic review finds levetiracetam linked to psychobehavioral adverse effects in epilepsy

This is a systematic review examining psychobehavioral adverse effects (PBAEs) associated with levetiracetam use in epilepsy, including generalized and focal types. It synthesizes data on the frequency and impact of these effects, without reporting on study population, sample size, comparator, or follow-up duration.

Key findings include mean reported rates of specific PBAEs: irritability at 9.9%, anger at 2.5%, and aggressiveness at 2.6%. Discontinuation rates attributable to aggression and irritability ranged from 2.4% to 3.4%. The review notes that PBAEs are the most frequently reported adverse events, with others including neurological, dermatological, muscular, and hematological effects; serious adverse events include psychosis and suicidality.

The authors emphasize that the evidence is observational, with risk factors associated with increased likelihood but not causation. Limitations and practice relevance are not reported. Clinicians should interpret these findings cautiously, as the review does not provide pooled effect sizes, confidence intervals, or details on study design to assess certainty.