2020 issue 2


Volume 36, issue 2

Case report

Psychotic disorders as an adverse effect of levetiracetam or discontinuation of mood stabilising drugs

Katarzyna Kurczych1, Agnieszka Makulska1, Iwona Kurkowska-Jastrzębska1
1. Institute of Psychiatry and Neurology in Warsaw
Farmakoterapia w Psychiatrii i Neurologii 2020, 36 (2), 155–163
Date of publication: 03-08-2020
DOI: https://doi.org/10.33450/fpn.2020.06.003
Keywords: anxiety, valproic acid, levetiracetam, psychotic disorder, behavioral disorder, withdrawal of mood stabilizing drugs


Patients using antiepileptic drugs (AEDs) suffer from relatively common adverse effects manifested by psychotic and behavioural disorders. This is particularly true in patients with a history of psychiatric disorders and using levetiracetam. This has important therapeutic implications because very often discontinuation of AED is the only available option. Simultaneous use of mood-stabilising AEDs reduces this risk; however, too rapid withdrawal of such AEDs can also induce psychotic symptoms.

We present four cases of epilepsy patients who experienced psychiatric disorders induced by LEV. In one of them, they occurred after adding LEV to the treatment; in two – after discontinuation of a mood-stabiliser; and in one both modifications were made simultaneously. Our cases show that LEV-induced behavioural disorders are dose-dependent and do not always require discontinuation of the drug. This seems to be justified by good seizure control ensured by the use of LEV, and using mood-stabiliser reduces LEV adverse effects.

Address for correspondence:
Katarzyna Kurczych
Instytut Psychiatrii i Neurologii
ul. Sobieskiego 9
02-957 Warszawa
email: kkurczych@ipin.edu.pl