Main Research Findings

Levetiracetam is an effective treatment for epilepsy, but it can cause various side effects, particularly behavioral ones, which are more common in children than adults. 9 Some of the reported behavioral side effects include aggression, mood changes, and cognitive decline. 13 , 4 , 16 , 7 , 11 In addition, increasing the dose of levetiracetam can lead to severe behavioral changes. 3 There is evidence that supplementing with vitamin B6 (pyridoxine) may help reduce the severity of these side effects. 13 , 16 , 7 , 11 However, vitamin B6 is not a guaranteed solution for everyone, and its effectiveness may vary. 11 Therefore, close monitoring and individual adjustments are essential when managing levetiracetam therapy, and consultation with a healthcare professional is strongly advised for any concerns about side effects.

Reasons for Side Effects

The exact mechanisms by which levetiracetam affects behavior are not fully understood. However, it is believed that levetiracetam may influence the balance of neurotransmitters in the brain, which can lead to changes in mood, behavior, and cognition. 10 , 4 Additionally, levetiracetam might directly impact specific brain regions responsible for regulating behavior. 20 It is important to recognize that individual responses to medications can vary significantly due to factors such as drug metabolism and genetic variations. 10 , 4

Common Side Effects

Aggression

One of the more prominent side effects of levetiracetam is aggression, which may occur shortly after starting the medication or when the dosage is adjusted. 3 The risk of aggression can also increase when levetiracetam is combined with other antiepileptic drugs. 17 This side effect can be challenging, but careful monitoring and dose adjustments may help manage it. 3 It's crucial to discuss any concerns about aggression with your healthcare provider.

Mood Changes

Mood changes are another possible side effect of levetiracetam, and they can vary in severity. 4 , 13 These changes can include anxiety, agitation, depression, hallucinations, and delusions. 1 In some cases, these mood changes can be severe and require immediate attention from a healthcare professional. 1 Open communication with your doctor about any mood changes you experience is important for proper management.

Cognitive Decline

Levetiracetam can also cause cognitive decline, which can manifest as problems with memory, concentration, and overall mental clarity. 8 , 14 These cognitive changes may appear early in treatment or may worsen over time. 8 , 14 If you notice cognitive difficulties, discuss them with your healthcare provider to determine the best course of action.

Other Side Effects

In addition to the behavioral side effects, levetiracetam can also cause various other side effects, including fatigue, dizziness, headache, loss of appetite, weight gain, constipation, diarrhea, rash, and allergic reactions. 19 In rarer cases, serious side effects such as rhabdomyolysis (muscle breakdown) and QT prolongation (heart rhythm problems) may occur. 2 , 19 It is crucial to report any unusual or concerning symptoms to your doctor promptly.

Measures to Counteract Side Effects

Aggression

If you are experiencing aggression as a side effect of levetiracetam, adjusting the dosage according to your doctor's guidance is essential. 3 In some cases, discontinuing the use of levetiracetam may be necessary if the aggression doesn't improve. 12 Open communication with your doctor about any aggressive behaviors is crucial for appropriate management.

Mood Changes

Adjusting the dosage as directed by your doctor is often the first step in managing mood changes related to levetiracetam. 4 If these changes persist, your doctor may recommend discontinuing the medication. 12 Don't hesitate to speak with your healthcare provider about any noticeable mood changes, as they can provide guidance and support.

Cognitive Decline

Adjusting the dosage of levetiracetam under your doctor's supervision is the primary approach to managing cognitive decline. 8 If these cognitive difficulties don't improve, discontinuing the medication may be considered. 12 It's important to discuss any concerns about cognitive function with your doctor for proper evaluation and management.

Other Side Effects

Individual responses to medications can vary greatly, so it's crucial to consult your doctor about any side effects you experience. 2 , 18 As a general precaution, it's advisable to avoid alcohol consumption while taking levetiracetam, as alcohol can worsen some side effects. 19 Prompt communication with your healthcare provider is essential for ensuring your safety and well-being.

Comparison Between Studies

Commonalities of Studies

Multiple research studies have indicated that levetiracetam can lead to behavioral side effects, particularly in children. 9 , 13 , 4 , 16 , 7 , 11 Several studies have also suggested that vitamin B6 supplementation might be helpful in reducing the severity of these side effects. 13 , 16 , 7 , 11

Differences in Studies

While there are commonalities, variations exist between studies in terms of the specific types and severity of side effects, as well as the effectiveness of vitamin B6 supplementation. 13 Additionally, differences in research methodology and participant characteristics can influence the findings, making direct comparisons challenging. 11 Further research is crucial to provide a more comprehensive understanding of the side effects of levetiracetam and how to best manage them.

Cautions for Application to Real Life

For individuals taking levetiracetam, adherence to the prescribed dosage and close monitoring for any side effects are paramount. 18 It is essential to remember that individual responses to medications can vary. 4 Also, levetiracetam can interact with other medications, so it's crucial to inform your doctor about all medications and supplements you are taking. 19 Never make adjustments to your dosage or stop taking levetiracetam without consulting your healthcare provider. 2 Open communication and close medical supervision are vital for managing levetiracetam therapy effectively.

Limitations of Current Research

Research on the side effects of levetiracetam is still ongoing, and there is more to learn. 4 Specifically, the mechanisms by which levetiracetam affects behavior require further investigation. 10 Additionally, more research is needed to develop effective strategies for mitigating side effects and identifying individuals who may be at higher risk. 16

Future Research Directions

Continued research on the side effects of levetiracetam is essential to improve our understanding of this medication. 14 Future research should focus on developing effective ways to reduce side effects, identifying individuals who are more susceptible to them, and exploring genetic factors that may influence susceptibility. 4 Further investigation into the genetic basis of side effects could also provide valuable insights. 10

Conclusion

Levetiracetam is a valuable treatment option for epilepsy, but it is important to be aware of its potential side effects. 13 If you are taking levetiracetam, follow your doctor's instructions carefully and report any side effects immediately. 18 Continued research is essential to enhance our understanding of levetiracetam's side effects and develop better management strategies. 14 Open communication with your healthcare provider is key to ensuring safe and effective treatment.