Psychiatric Adverse Effects of Levetiracetam in Malignant Glioma Populations; a Retrospective Cohort Study

Objective: Levetiracetam is commonly used in malignant glioma populations because of its efficacy, limited drug-drug interactions and adverse effects. Although, there has been growing evidence of adverse neuropsychiatric side effects from levetiracetam; however, such evidence in malignant brain tumo...

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Autores principales:	Paul Thisayakorn, Isabel Schuermeyer
Formato:	article
Lenguaje:	EN
Publicado:	Prince of Songkla University 2021
Materias:	drug-related side effects and adverse reactions glioma levetiracetam mental disorders Medicine R
Acceso en línea:	https://doaj.org/article/2719ee7b09eb47e882fdd9822721fa80
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spelling	oai:doaj.org-article:2719ee7b09eb47e882fdd9822721fa802021-11-25T08:25:12ZPsychiatric Adverse Effects of Levetiracetam in Malignant Glioma Populations; a Retrospective Cohort Study2586-99812630-055910.31584/jhsmr.2021814https://doaj.org/article/2719ee7b09eb47e882fdd9822721fa802021-11-01T00:00:00Zhttps://www.jhsmr.org/index.php/jhsmr/article/view/814https://doaj.org/toc/2586-9981https://doaj.org/toc/2630-0559Objective: Levetiracetam is commonly used in malignant glioma populations because of its efficacy, limited drug-drug interactions and adverse effects. Although, there has been growing evidence of adverse neuropsychiatric side effects from levetiracetam; however, such evidence in malignant brain tumor settings is limited. Hence, we hypothesized that malignant glioma patients exposed to levetiracetam would also experience more adverse neuropsychiatric effects compared to patients not receiving this medication. Material and Methods: A retrospective cohort analysis was conducted in 150 high grade malignant glioma patients at our Cleveland Clinic Cancer Center; from 2013-2014, comparing the accumulative adverse neuropsychiatric outcomes between patients who received levetiracetam and patients who did not (n=108 and 42, respectively). A sub-analysis of each specific neuropsychiatric side effect between these two groups was performed. Results: Patients with malignant glioma receiving levetiracetam had increased risk of developing neuropsychiatric adverse effects compared to the non-levetiracetam group (odds ratio=2.08, p-value=0.040, 95% confidence interval=1.00-4.36). After adjusting for confounding factors, past psychiatric history and the interaction between seizure and levetiracetam use was significantly associated with neuropsychiatric problems. Delirium, psychosis, and irritability were more common in the levetiracetam group, and likely led to more psychiatric referrals, starting of psychotropic medications, and vitamin B6 use. Conclusion: Incidence of neuropsychiatric presentations in malignant glioma patients was higher in the levetiracetam exposed group than the non-exposed group. The changes, or emergence of new neuropsychiatric behaviors should prompt clinicians to search for possible causes; including levetiracetam adverse effects, so they can be managed accordingly.Paul ThisayakornIsabel SchuermeyerPrince of Songkla Universityarticledrug-related side effects and adverse reactionsgliomalevetiracetammental disordersMedicineRENJournal of Health Science and Medical Research (JHSMR), Vol 40, Iss 1, Pp 27-34 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	drug-related side effects and adverse reactions glioma levetiracetam mental disorders Medicine R
spellingShingle	drug-related side effects and adverse reactions glioma levetiracetam mental disorders Medicine R Paul Thisayakorn Isabel Schuermeyer Psychiatric Adverse Effects of Levetiracetam in Malignant Glioma Populations; a Retrospective Cohort Study
description	Objective: Levetiracetam is commonly used in malignant glioma populations because of its efficacy, limited drug-drug interactions and adverse effects. Although, there has been growing evidence of adverse neuropsychiatric side effects from levetiracetam; however, such evidence in malignant brain tumor settings is limited. Hence, we hypothesized that malignant glioma patients exposed to levetiracetam would also experience more adverse neuropsychiatric effects compared to patients not receiving this medication. Material and Methods: A retrospective cohort analysis was conducted in 150 high grade malignant glioma patients at our Cleveland Clinic Cancer Center; from 2013-2014, comparing the accumulative adverse neuropsychiatric outcomes between patients who received levetiracetam and patients who did not (n=108 and 42, respectively). A sub-analysis of each specific neuropsychiatric side effect between these two groups was performed. Results: Patients with malignant glioma receiving levetiracetam had increased risk of developing neuropsychiatric adverse effects compared to the non-levetiracetam group (odds ratio=2.08, p-value=0.040, 95% confidence interval=1.00-4.36). After adjusting for confounding factors, past psychiatric history and the interaction between seizure and levetiracetam use was significantly associated with neuropsychiatric problems. Delirium, psychosis, and irritability were more common in the levetiracetam group, and likely led to more psychiatric referrals, starting of psychotropic medications, and vitamin B6 use. Conclusion: Incidence of neuropsychiatric presentations in malignant glioma patients was higher in the levetiracetam exposed group than the non-exposed group. The changes, or emergence of new neuropsychiatric behaviors should prompt clinicians to search for possible causes; including levetiracetam adverse effects, so they can be managed accordingly.
format	article
author	Paul Thisayakorn Isabel Schuermeyer
author_facet	Paul Thisayakorn Isabel Schuermeyer
author_sort	Paul Thisayakorn
title	Psychiatric Adverse Effects of Levetiracetam in Malignant Glioma Populations; a Retrospective Cohort Study
title_short	Psychiatric Adverse Effects of Levetiracetam in Malignant Glioma Populations; a Retrospective Cohort Study
title_full	Psychiatric Adverse Effects of Levetiracetam in Malignant Glioma Populations; a Retrospective Cohort Study
title_fullStr	Psychiatric Adverse Effects of Levetiracetam in Malignant Glioma Populations; a Retrospective Cohort Study
title_full_unstemmed	Psychiatric Adverse Effects of Levetiracetam in Malignant Glioma Populations; a Retrospective Cohort Study
title_sort	psychiatric adverse effects of levetiracetam in malignant glioma populations; a retrospective cohort study
publisher	Prince of Songkla University
publishDate	2021
url	https://doaj.org/article/2719ee7b09eb47e882fdd9822721fa80
work_keys_str_mv	AT paulthisayakorn psychiatricadverseeffectsoflevetiracetaminmalignantgliomapopulationsaretrospectivecohortstudy AT isabelschuermeyer psychiatricadverseeffectsoflevetiracetaminmalignantgliomapopulationsaretrospectivecohortstudy
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Psychiatric Adverse Effects of Levetiracetam in Malignant Glioma Populations; a Retrospective Cohort Study

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