Behavioral Effects and Somnolence Due to Levetiracetam Versus Oxcarbazepine: A Retrospective Comparison Study of North Indian Patients with Refractory Epilepsy

    October 2016 in “ Epilepsy & behavior ”
    Garima Shukla, Anupama Gupta, Priya Agarwal, S. Poornima
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    TLDR Levetiracetam often causes behavioral issues, while oxcarbazepine is more likely to cause sleepiness in epilepsy patients.
    In a retrospective study of 292 patients (93 females, median age: 21 years) with refractory epilepsy, behavioral disturbances such as irritability, obsessive manifestations, aggressiveness, and psychosis were observed in 43 patients, with 23 (20.2%) experiencing these upon the introduction of levetiracetam (LEV). LEV was discontinued in 10 (9%) of these cases due to behavioral side effects. Daytime somnolence was reported by 28 patients, with 15 (10%) on oxcarbazepine (OXC) experiencing this issue, and 8 of those were treated with oral modafinil. Only 1 patient on LEV and 3 on valproate (VPA) reported excessive daytime sleepiness (EDS). Additionally, 9 reported menstrual disturbances, 3 reported weight gain, and 2 females on VPA reported severe hair loss. The study concluded that behavioral disturbances are common with LEV, while somnolence is more associated with OXC, suggesting that these side effects should be considered when selecting antiepileptic drugs for patients with refractory epilepsy.
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