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Behavioural changes in patients with intellectual disability treated with brivaracetam
E Andres1, F Kerling1, H Hamer2
1Department of Neurology, Epilepsy Center, Sana-Krankenhaus Rummelsberg (teaching hospital of the Friedrich-Alexander-Universität Erlangen-Nürnberg), Schwarzenbruck, Germany.
Acta Neurologica Scandinavica
|April 17, 2018
Summary
Brivaracetam (BRV) showed limited efficacy in difficult-to-treat epilepsy patients with intellectual disability, with a 19% responder rate. Behavioral changes, particularly aggression, were noted in 13 patients, indicating a potential risk factor.
Area of Science:
- Epileptology and Neuroscience
- Pharmacology and Therapeutics
- Intellectual Disability Research
Background:
- Drug-resistant epilepsy is a significant challenge, particularly in patients with intellectual disability (ID).
- Evaluating novel antiepileptic drugs like brivaracetam (BRV) is crucial for this patient population.
Purpose of the Study:
- To assess the tolerability and efficacy of brivaracetam (BRV) in residential patients with drug-resistant epilepsy and ID.
- To evaluate seizure frequency reduction, retention rates, and behavioral changes associated with BRV treatment.
Main Methods:
- Retrospective analysis of 33 patients with ID and drug-resistant epilepsy.
- Non-interventional study comparing 3-month baseline seizure frequency with 3-month post-BRV treatment.
- Utilized seizure diaries, Clinical Global Impression (CGI) scale, and Aggressive Behaviour Scale (ABS).
Main Results:
- A 19% responder rate (≥50% seizure reduction) was observed.
- The 12-month retention rate was 37%, with treatment discontinuation due to adverse events or lack of efficacy.
- Thirteen patients experienced behavioral changes, including aggression (ABS deterioration in 13), ataxia, gastrointestinal issues, and sedation.
Conclusions:
- Brivaracetam (BRV) demonstrates efficacy in a subset of patients with difficult-to-treat epilepsy and intellectual disability.
- A significant number of patients experienced challenging behavioral changes, with psychiatric illness identified as a risk factor.
- Further research is warranted to optimize BRV use and manage associated behavioral side effects in this population.
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