Levetiracetam induced hypomania: a case report

Area of Science:

• Neurology
• Psychiatry
• Pharmacology

Background:

• Levetiracetam (LEV) is a widely used second-generation antiepileptic drug effective for various seizure types.
• LEV is generally recognized for its favorable safety profile with fewer adverse drug reactions compared to other antiepileptics.
• While psychiatric side effects of LEV are documented, manic episodes are rarely reported.

Observation:

• This report details a case of a patient with no prior psychiatric history who developed hypomania after initiating LEV treatment for epilepsy.
• The patient exhibited symptoms of hypomania, a less severe form of mania, during LEV therapy.
• This presentation is unusual given the established side effect profile of LEV.

Findings:

• The case suggests a potential, albeit rare, link between LEV administration and the induction of manic or hypomanic symptoms.
• This finding is significant as only three prior case reports have documented LEV-induced mania.
• The patient's lack of a previous psychiatric disorder underscores the potential for LEV to trigger such episodes in susceptible individuals.

Implications:

• Clinicians should maintain a high index of suspicion for psychiatric disturbances, including mania, in patients treated with LEV.
• Close monitoring for psychological and psychotic symptoms is crucial during LEV therapy.
• This case contributes to the understanding of rare adverse psychiatric effects associated with antiepileptic drugs like LEV.